| CT联合血清HCY、β2-M在下肢动脉狭窄闭塞性疾病中的诊断价值 |
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| 引用本文： | 何辉,沈洪晖.CT联合血清HCY、β2-M在下肢动脉狭窄闭塞性疾病中的诊断价值[J].影像科学与光化学,2019,37(4):349-355. |
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| 作者姓名： | 何辉 沈洪晖 |
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| 作者单位： | 上海市闵行区颛桥社区卫生服务中心,上海,201108;上海市金山区中西医结合医院,上海,201501 |
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| 摘 要： | 本文对CT联合血清同型半胱氨酸（HCY）、β2-微球蛋白（β2-M）在下肢动脉狭窄闭塞性疾病中的诊断价值进行分析。选取上海市金山区中西医结合医院收治的120例疑似下肢动脉狭窄闭塞性疾病患者进行研究，选取同期健康体检者120例作为对照组，对患者进行CT检查、血清HCY和β2-M水平检查，并比较了CT诊断下肢动脉狭窄闭塞情况、两组患者血清HCY和β2-M水平，以明确CT、HCY、β2-M诊断价值及误诊率、漏诊率。结果显示，120例疑似患者中，CT检测出646节段病变血管，其中轻度狭窄155节段，中度狭窄257节段，重度狭窄143节段，血管完全闭塞91节段；研究组患者血清HCY、β2-M水平明显高于对照组，两组比较差异有统计学意义（P<0.05）；HCY的AUC为0.863，截断值>21.75（μmol/L），诊断敏感性为79.00%，特异性为80.00%，β2-M的AUC为0.837，截断值>2.98（μmol/mL），诊断敏感性为75.25%，特异性为65.21%；CT诊断阳性率为67.50%，HCY诊断阳性率为69.17%，β2-M诊断阳性率为67.50%，三者联合诊断阳性率为82.50%，联合诊断阳性率高于CT、HCY、β2-M单独诊断阳性率（P<0.05）；CT、HCY、β2-M单一检测对下肢动脉狭窄闭塞性疾病均有较高灵敏度、特异性及准确度，但三者联合诊断灵敏度、特异性及准确度最高，误诊率、漏诊率最低。本文证实了采用CT联合血清HCY、β2-M诊断下肢动脉狭窄闭塞性疾病诊断灵敏度、特异性及准确度高，误诊率、漏诊率低。
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| 关 键 词： | 下肢动脉狭窄闭塞性疾病 CT 同型半胱氨酸 β2-微球蛋白 |
| 收稿时间： | 2019-05-09 |
The Diagnostic Value of CT Combined with Serum HCY and β2-M in Arterial Stenosis and Occlusion of Lower Extremity |
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| HE Hui,SHEN Honghui.The Diagnostic Value of CT Combined with Serum HCY and β2-M in Arterial Stenosis and Occlusion of Lower Extremity[J].Imaging Science and Photochemistry,2019,37(4):349-355. |
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| Authors: | HE Hui SHEN Honghui |
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| Affiliation: | 1. Zhunqiao Community Health Service Center, Minhang District, Shanghai 201108, P. R. China;
2. The Hospital of Integrated Traditional Chinese and Western Medicine, Jinshan District, Shanghai 201501, P. R. China |
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| Abstract: | In this paper, the diagnostic value of CT combined with serum homocysteine (HCY) and beta 2-microglobulin (beta 2-M) in lower extremity arterial stenosis and occlusive disease was analyzed. 120 patients with suspected lower extremity artery stenosis and occlusive disease were selected as the study group, and 120 healthy people in the same period were selected as the control group, CT examination, serum HCY and β2-M levels examination were performed. CT diagnosis of lower extremity arterial stenosis and occlusion, the serum HCY and β2-M levels were compared. In this paper, the diagnostic values of CT, HCY, and β2-M in two groups were analyzed, and the misdiagnosis rate and missed diagnosis rate were also analyzed. The results showed that, among 120 patients, 646 lesions were detected by CT, including 155 slight stenosis, 257 moderate stenosis, 143 severe stenosis, and 91 complete occlusion; the levels of serum HCY and β2-M in the study group were significantly higher than those in the control group, the difference between the two groups was statistically significant (P<0.05). The AUC of HCY was 0.863, truncation value >21.75 (mol/L), diagnostic sensitivity was 79.00%, specificity was 80.00%, the AUC of β2-M was 0.837, truncation value >2.98 mol/mL, diagnostic sensitivity was 75.25%, specificity was 65.21%; the positive rate of CT diagnosis, HCY diagnosis, β2-M diagnosis, and three combined diagnosis were 67.50%, 69.17%, 67.50%, and 82.50%, respectively. The positive rate of combined diagnosis was higher than that of CT, HCY, and β2-M single diagnoses (P<0.05); CT, HCY, and β2-M single diagnoses had high sensitivity, specificity, and accuracy for lower extremity artery stenosis and occlusion disease, but the combined diagnosis of the three had the highest sensitivity, specificity, and accuracy, and the misdiagnosis rate and missed diagnosis rate were the lowest. |
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| Keywords: | lower extremity arterial stenosis and occlusive disease CT homocysteine β2-microglobulin |
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