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目的探讨B型脑钠肽(BNP)和可溶性血管细胞黏附分子1(sVCAM-1)水平在T2DM合并冠心病(CHD)危险分层中的临床意义。方法选取T2DM合并CHD患者(T2DM+CHD组)64例和T2DM未合并CHD患者(T2DM组)64例,进一步将T2DM+CHD组分为急性心肌梗死(AMI)亚组、不稳定型心绞痛(UAP)亚组和稳定型心绞痛(SAP)亚组,检测各组BNP、sVCAM-1等指标水平。结果与T2DM组相比,T2DM+CHD组血清BNP、sVCAM-1水平升高,且各亚组间比较差异有统计学意义(P<0.01)。BNP、sVCAM-1与HbA1c呈正相关,且BNP与sVCAM-1呈正相关(r=0.376,P<0.05;r=0.652,P<0.05;r=0.309,P<0.05)。Logistic多元回归分析显示,HbA1c、TC、LDL-C、BNP和sVCAM-1是T2DM合并CHD发生的危险因素。结论联合检测血清BNP、sVCAM-1水平对T2DM合并CHD危险分层有重要的判断意义,BNP可作为预测T2DM患者心血管病变的标记物。
Objective To investigate the clinical significance of serum brain natriuretic peptide (BNP) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in the risk stratification of T2DM with coronary heart disease (CHD). Methods Sixty-four patients with T2DM and CHD (T2DM + CHD group) and 64 patients with T2DM without T2DM (T2DM group) were further divided into two groups: AMI group, UAP ) Subgroup and stable angina pectoris group (SAP). The levels of BNP and sVCAM-1 in each group were detected. Results Compared with T2DM group, the levels of serum BNP and sVCAM-1 in T2DM + CHD group were significantly higher than those in T2DM group (P <0.01). BNP and sVCAM-1 were positively correlated with HbA1c, and there was a positive correlation between BNP and sVCAM-1 (r = 0.376, P <0.05; r = 0.652, P <0.05; r = 0.309, P <0.05). Logistic multivariate regression analysis showed that HbA1c, TC, LDL-C, BNP and sVCAM-1 were the risk factors of T2DM with CHD. Conclusions The combined detection of serum BNP and sVCAM-1 levels is of great significance in the diagnosis of T2DM with CHD. BNP can be used as a marker for predicting cardiovascular disease in T2DM patients.