摘要
目的观察2型糖尿病（DM2）患者促血小板生成素（TPO）及平均血小板体积（MPV）水平，探讨其在DM2合并冠心病（CHD）和合并急性冠脉综合征（ACS）中的应用价值。方法检测134例2型糖尿病患者（DM2组）以及39例健康志愿者（对照组）TPO、MPV以及心肌肌钙蛋白I（cTnI）水平，分析ACS患者TPO和MPV与cTnI的相关性，运用ROC曲线评价TPO和MPV对DM2合并CHD和合并ACS的预测价值。结果DM2组TPO和MPV水平均显著高于对照组，合并CHD组TPO和MPV水平均显著高于单纯DM2组（P=0．000）；合并ACS组TPO和MPV水平均显著高于合并稳定型心绞痛组（P〈0．01）。合并ACS的患者中，合并ST段抬高性心肌梗死（STEMI）组TPO水平显著高于非ST段抬高性心肌梗死（NSTEMI）组，NSTEMI组其水平也显著高于不稳定型心绞痛（UA）组（P〈0．01）。合并ACS的患者TPO水平与cTnI水平呈高度正相关（r=0．906，P=0．000）。TPO和MPV预测DM2合并CHD的ROC曲线下面积分别为0．911（95％CI：0．862～0．960）和0．835（95％CI：0．760～0．909），其cutoff值为83．2pg／ml和11．5n，敏感度为88．8％和78．7％，特异性为83．3％和85．7％；TPO和MPV预测DM2合并ACS的ROC曲线下面积为0．876（95％CI：0．820～0．932）和0．761（95％CI：0．68～0．842），cutoff值为97．3pg／ml和12．3n，敏感度为91．0％和83．1％，特异性为81．0％和88．1％。结论TPO和MPV可用于预测DM2合并CHD和ACS发生，TPO有助于合并ACS患者的病情判断。
Objective To observe the levels of thrombopoietin （TPO） and mean platelet volume （MPV） in patients with type 2 diabetes mellitus, and to explore their clinical significance in complicating coronary heart disease （CHD） and acute coronary syndrome （ACS）. Methods Levels of TPO, MPV, and cardiac troponin I （cTnI） were measured in 134 patients with type 2 diabetes mellitus （ group DM2） , and 39 healthy volunteers （ group control）. The correlation was analyzed between TPO or MPV and cTnI. And the receiver operating characteristic （ROC） curve was used to evaluate the predicting significance of TPO and MPV on complicating CHD and ACS in DM2 patients. Results In group DM2, TPO and MPV levels were significantly higher those that in group control. They were significantly higher in group complicating CHD and group ACS than in group single DM2 and group stable angina, respectively （P 〈 0.01 ）. In complicating ACS patients, TPO level in group ST - segment elevation myocardial infarction （STEMI） was significantly higher than that in group non - ST - segment elevation myocardial infarction （NSTEMI） , and it was notably higher in group NSTEMI than in group unstable angina （ P 〈 0.01 ）. In ACS patients, TPO level was significantly correlated with cTnI level （ r = 0. 906,P = 0. 000）. The area under ROC curve of TPO and MPV in prediction for complicating CHD of DM2 patients were 0. 911 （95% C1：0. 862 - 0. 960） and 0. 835 （95% C1：0. 760 - 0. 909 ） , respectively, and the cutoff values were 83.2pg/ml and 11.5fl, and the sensitivity were 88.8% and 78.7% , specificity were 83.3% and 85.7% , respectively. The area under ROC curve of TPO and MPV in prediction for complicating ACS of DM2 patients were 0. 876（95% C1：0. 820 -0. 932） and 0. 761 （95% C1：0.68 -0. 842）, respectively, and the cutoff values were 97.3pg/ml and 12.3fl, and the sensitivity were 91.0% and 83.1% , and specificity were 81.0% and 88.1% , respectively. Conclusion TPO and MPV can be used to predict the occurrence of CHD and ACS in DM2 patients, and TPO is helpful to evaluate the disease condition of complicating ACS.
出处
《医学研究杂志》
2016年第10期128-131,141,共5页
Journal of Medical Research
关键词
2型糖尿病
冠心病
急性冠脉综合征
促血小板生成素
平均血小板体积
Type 2 diabetes mellitus
Coronary heart disease
Acute coronary syndrome
Thrombopoietin
Mean platelet volume
