摘要
目的探讨在2型糖尿病患者中,血清可溶性ST2(sST2)对左心室舒张功能紊乱(LVDD)的诊断价值;比较血清sST2与脑钠肽(BNP)对LVDD诊断价值的优劣。方法选取2010年11月至2012年12月于内分泌科住院的2型糖尿病患者119例,收集其临床资料并检测生化指标(甘油三酯、总胆固醇、空腹及餐后2h血清胰岛素、C肽、糖化血红蛋白、BNP等)。所有入组病例接受全面的超声心动图检查以评估左心室舒张功能,并将病例分为以下三组:正常组23例、松弛受损组31例、伪正常组65例。应用酶联免疫吸附法(ELISA)检测血清sST2水平。结果 (1)松弛受损组、伪正常组血清sST2、BNP水平均比正常组显著增高(P<0.05)。(2)血清sST2诊断LVDD的ROC曲线下面积为0.847[95%置信区间(CI):0.75～0.95,P=0.000]。BNP曲线下面积为0.696(95%CI:0.58～0.82,P=0.005)。两者联合诊断时曲线下面积为0.860(95%CI:0.78～0.94,P=0.000)。结论在2型糖尿病患者中,血清sST2对LVDD具有诊断价值,其诊断价值优于BNP;血清sST2独立诊断LVDD的价值不劣于两者联合诊断。
Objective To investigate the diagnostic value of serum soluble ST2 （sST2）levels in patients with type 2 diabetes for left ventricular diastolic dysfunction（LVDD）.A secondary aim was to compare the diagnostic role between serum sST2 and brain natriuretic peptide （BNP）for detecting LVDD.Methods One hundred and nineteen patients with type 2 diabetes,who were hospitalized in the endocrinology department during Nov.2010 to Dec.2012,were recruited to receive clinical evaluation and biochemical detections （triglyceridemia,cholesterolemia,fasting and 2-hour postprandial blood serum insulin and C peptide,glycosylated hemoglobin and BNP）.All of them underwent a complete Doppler-echocardiographic evaluation of left ventricular diastolic function.According the result,all subjects were divided into 3 groups as follows：normal （n =23）,impaired relaxation （n =31） and pseudonormal filling pattern（n =65）.The levels of serum sST2 were determined by ELISA technique.Results The levels of serum sST2 were significantly higher in patients with impaired relaxation,and pseudonormal tilling pattern than in patients with normal （P ＜ 0.05）.Receiver-operator characteristic curves （ROC） for diagnosis of LVDD demonstrated an AUC of 0.847 for sST2 [95 ％ confidence interval（CI）：0.75 to 0.95 ;P =0.000],an AUC of 0.696 for BNP（95％ CI：0.58 to 0.82 ;P =0.005）,an AUC of 0.860 for combination of both biomarkers（95％ CI：0.78 to 0.94 ; P =0.000）.Conclusions Serum soluble ST2 can be used for diagnosis of LVDD in diabetic patients,and it is better than BNP.The independent diagnostic value of serum sST2 for LVDD is not be inferior to the joint diagnosis.
出处
《中华临床医师杂志（电子版）》
CAS
2013年第6期35-38,共4页
Chinese Journal of Clinicians(Electronic Edition)
基金
国家自然科学基金(81270908)
关键词
糖尿病
2型
利钠肽
脑
sST2
左心室舒张功能紊乱
Diabetes mellitus, type 2
Natriuretic peptide, brain
Soluble ST2
Left ventricular diastolic dysfunction
