| Background Nowdays,how to give early diagnosis, assessment and timely intervention for the patients diagnosed with T2 DM complicated with CHD is a hotspot in clinical research. As the development of noninvasive arteriosclerosis detection technology, many studies have shown that it have certain predictive judgment value in the early atherosclerosis.Objective The study was aimed to explore the correlation respectively between the ankle-arm pulse wave velocity(ba PWV) and carotid intima-media thickness(IMT)detection technology with T2 DM complicated with CHD,and the predictive value of T2 DM complicated with CHD.Methods Selected 78 cases who were diagnosed with T2 DM in hospital from Jul. 2015 to Feb. 2016.All case accepted ba PWV, carotid color ultrasonography and coronary angiography(CAG). Then all cases were divided into T2DM- CHD group(42 cases) and T2 DM group(36 cases) according to the CAG results.(1)Compared the baseline data, biochemical examination, ba PWV, IMT and the incidence of carotid plaques between the two groups.(2)Compared the ba PWV and IMT between different coronary lesions counts groups, different degree of coronary artery lesions.(3)Respectively analyed the correlation between ba PWV, IMT and Gensini score.(4)According to the outcomes of CAG as the gold standard, evaluated the application value of ba PWV and IMT in patients with T2 DM complicated with CHD by drawing ROC curve.(5)Applyed the binary logistic regression to analy what risk factors effect T2 DM patients complicated with CHD.Results(1)Compared the clinical baseline data of two groups,except BMI, in gender, age, the history of high blood pressure,the smoking history, there were no statistically significant difference. Two groups were comparable.(2)Compared two groups,in HDL, Hb A1 c,ba PWV( T2DM-CHD group 1416.24±146.31cm/s,T2 DM group 1297.75±65.78cm/s)? IMT( T2DM-CHD group 1.11±0.16 mm, T2 DM group 1.0mm), the difference,(P < 0.05).On the contrary,the difference in CHO, TG, LDL and the incidence of carotid plaques had no statistical significance( P> 0.05).(3)Between the different coronary lesions counts groups:the difference of ba PWV: single branch group, double branches group were respectively different from multivessel branches group(P < 0.05).The difference of IMT:single branch group, double branches group were respectively different from multivessel branches group(P < 0.05).(4)Between different degree of coronary artery lesions: the difference of ba PWV: normal group, the mild lesion group and moderate lesion group were respectively different from severe lesion group,(P < 0.05). The difference of IMT, there were no different between each two of four groups.(5)There was a positive correlation between ba PWV and Gensini score(ba PWV r=0.674),same to the IMT(IMT r=0.331), P<0.01.(6)Drawed up the ROC curve of the ba PWV and IMT,the AUC of ba PWV was 0.759,the AUC of IMT was 0.690. It showed that ba PWV had medium predictive value in diagnosis of CHD, the value of IMT was lower.The best cut-off point for screening of CHD were ba PWV 1410cm/s,IMT 1.05 mm. Detected both and comprehensive judged the results may improve the diagnostic value.(7)The CAG results as the dependent variable, through binary logisitic regression analysis,shown that Hb A1c( OR 9.741)?CHO(OR 18.433)?BMI(OR 7.567)?ba PWV(OR 12.372),considered as the risk factors that influented T2 DM complicated with CHD.Conclusion Ba PWV, IMT had the early screening value for diagnosis of T2 DM with CHD, predictive value of the ba PWV was slightly higher than IMT,detected both and integrated the results to judge would had higher value. Value for coronary lesion count judgment,ba PWV was as good as IMT. Value for coronary artery lesion severity judgment, ba PWV was better than IMT. Obesity, CHO, Hb A1 c were the risk factors of T2 DM with CHD in this study. |
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