两种方法检测超敏C反应蛋白诊断2型糖尿病患者颈动脉内中膜厚度的价值

两种方法检测超敏C反应蛋白诊断2型糖尿病患者颈动脉内
中膜厚度的价值
李娟红;赵子贤;曾凤群;利雯秀;陈世豪;叶青云;李敬红
【期刊名称】《海南医学》
【年(卷),期】2016(0)16
【摘要】Objective To evaluate the value of hypersensitive C-reaction protein (hs-CRP) detected by two assays in diagnosing increased carotid intima-media thickness (IMT) of patients with type 2 diabetes mellitus. Methods With the findings of cervical vascular color Doppler ultrasound examination as standard, 84 patients with T2DM, who admitted to our hospital from April 2013 to April 2015, were chosen and divided into the normal IMT group (n=40, IMT<0.9 mm) and the IMT increased group
(n=44, IMT≥0.9 mm) according to the IMT level. At the same time, 42 healthy people were cho-sen as the control group. The whole blood and serum concentration of hs-CRP in the patients of normal IMT group, IMT increased group and control group were detected by latex-enhanced immunonephelometry method and partied-enhanced turbidimetric immunoassay respectively. The application value of the two assays in the diagnosis of patients of type 2 dia-betes mellitus with increased carotid intima-media thickness was evaluated by the receiver operating characteristic (ROC) curve. In addition, the total cholesterol combined with hs-CRP were detected to evaluate the application value of the diag-nosis
of patients of type 2 diabetes mellitus with increased carotid intima-media thickness. Results The two assays showed that the level of hs-CRP in whole blood and serum of IMT increased group [(4.78±1.04) mg/L, (4.43±0.95)
mg/L, respectively] were significantly higher than those of the normal IMT group [(1.85±0.78) mg/L, (1.70±0.89) mg/L, respec-tively] and the healthy control [(0.98±0.67) mg/L and (0.87±0.59) mg/L] (P<0.05). The ROC curve analysis showed that the latex-enhanced immunonephelometry method had higher sensitivity (76.2%) and lower specificity (47.1%), with the areas under ROC curve for 0.612; the partied-enhanced turbidmetric method
had lower sensitivity (69.0%) and higher specificity (52.9%), with the areas under ROC curve for 0.596. Compared to the single index test, the sensitivity of hs-CRP and total cholesterol combination detection had higher sensitivity (83.3%) and higher specificity (64.7%), with the areas under ROC curve for 0.732. Conclusion The blood hs-CRP level rises with the increase of IMT in the pa-tients with T2DM. The latex-enhanced immunonephelometry method is better than the partied-enhanced turbidimetric immunoassay method in the diagnostic performance of increased carotid intima-media thickness of T2DM. The combina-tion detection of hs-CRP and total cholesterol can improve the diagnostic sensitivity and specificity.%目的：探讨两种方法检测超敏C反应蛋白(hs-CRP)
对2型糖尿病(T2DM)患者颈动脉内中膜厚度（IMT）增加的诊断价值。

方法选择2013年4月至2015年4月我院收治的84例T2DM患者，以彩色多普勒超声诊断仪检查患者颈动脉的结果为标准，按IMT<0.9 mm和IMT≥0.9 mm分成颈动
脉正常组40例和颈动脉增厚组44例。

同期另选42例健康查体者为正常对照组，
分别采用乳胶增强免疫散射比浊法和颗粒增强免疫透射比浊法检测所有受检者的全血hs-CRP和血清hs-CRP的水平，用受试者工作特征(ROC)曲线评价两种方法检测hs-CRP对T2DM患者IMT增加的诊断效能。

另用总胆固醇(TC)联合全血hs-CRP检测评价对T2DM患者IMT增加的诊断效能。

结果两种方法显示IMT增厚
组的全血[(4.78±1.04) mg/L]和血清hs-CRP水平[(4.43±0.95) mg/L]均高于IMT 正常组[(1.85±0.78) mg/L和(1.70±0.89) mg/L]和正常对照组[(0.98±0.67) mg/L 和(0.87±0.59) mg/L]，差异均有统计学意义(P<0.05)。

用ROC曲线分析得全血
hs-CRP的诊断灵敏度(76.2%)较高，而特异性(47.1%)较低，曲线下面积为0.612，而颗粒增强免疫透射比浊法检测血清hs-CRP的诊断灵敏度(69.0%)较低，特异性(52.9%)较高，曲线下面积为0.596；全血hs-CRP联合总胆固醇(TC)诊断的灵敏
度(83.3%)和特异性(64.7%)，曲线下面积为0.732，均高于hs-CRP单项指标诊断效能。

结论 T2DM患者IMT增加时，血液中hs-CRP水平升高；乳胶增强免疫散射比浊法检测hs-CRP对T2DM患者IMT增加的诊断效能优于颗粒增强免疫透射比浊法；全血hs-CRP联合TC检测能提高对T2DM患者IMT增加的诊断灵敏度
和特异性。

【总页数】4页(P2615-2617,2618)
【作者】李娟红;赵子贤;曾凤群;利雯秀;陈世豪;叶青云;李敬红
【作者单位】南方医科大学附属新会医院检验科广东江门 529100;南方医科大学附属新会医院输血科广东江门 529100;南方医科大学附属新会医院检验科广东
江门 529100;南方医科大学附属新会医院检验科广东江门 529100;南方医科大学附属新会医院检验科广东江门 529100;南方医科大学附属新会医院检验科广东
江门 529100;南方医科大学附属新会医院内分泌科广东江门 529100
【正文语种】中文
【中图分类】R587.1
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