糖尿病视网膜病变患者血清中期因子和总胆红素变化研究
摘要
目的:研究总胆红素(TB)联合血清中期因子(MK)诊断糖尿病视网膜病变(DR)的价值,为临床诊断及治疗提供参考。方法:选取296例2型糖尿病患者,按照是否出现DR分为3组,即100例糖尿病无DR组(NDR)、104例非增殖性DR组(NPDR)、92例增殖性DR组(PDR)。对比各组受检者的尿白蛋白/肌酐比(UAIB/Cr)、直接胆红素(DB)及TB、MK变化,使用Logistic回归分析DR的危险因素,并研究TB、MK联合和单独诊断效能。结果:3组受检者相比,PDR组UAIB/Cr及MK均高于NPDR组,DB及TB均低于NPDR组;而NPDR组UAIB/Cr及MK均高于NDR组,而DB及TB均低于NDR组,差异均有统计学意义(P <0. 05)。Logistic回归分析显示UAIB/Cr及MK为DR的危险因素(OR值为1. 71、2. 35,P <0. 05),DB及TB为DR的保护因素(OR值为0. 46、0. 31,P <0. 05)。TB+MK联合诊断的阴性预测值、阳性预测值、特异性、敏感性、准确率均高于TB、MK单独诊断(曲线下面积(AUC)分别为0. 92、0. 74、0. 76,P <0. 05)。结论:糖尿病视网膜病变患者总胆红素及血清中期因子变化明显,即病情发展越晚血清中期因子升高,总胆红素水平降低,且两者联合诊断效能最佳,可为临床提供参考。
引文
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[9] Chidambara L,Jayadev C,Mangalesh S,et al. Correlation of Spectraldomain Optical Coherence Tomography with Fundus Fluorescein Angiography in an Infant with Retinal Hamartomas[J]. Eur J Ophthalmol,2015,25(6):106-108.
[10] Nobre Cardoso J,Keane PA,Sim DA,et al. Systematic Evaluation of Optical Coherence Tomography Angiography in Retinal Vein Occlusion[J]. Am J Ophthalmol,2016,163:93-107.
[11] Hayreh SS,Zimmerman MB. Fundus Changes in Branch Retinal Arteriolar Occlusion[J]. Retina,2015,35(10):2060-2066.
[2] Verma A,Shaikh S. Demonstration of Retinal Micro-emboli in a Case of Malaria Retinopathy by Fundus Fluorescein Angiography[J]. J Ophthalmic Vis Res,2015,10(4):491-492.
[3] Luttrull JK,Margolis BW. Functionally Guided Retinal Protective Therapy for Dry Age-related Macular and Inherited Retinal Degenerations:a pilot study[J]. Invest Ophthalmol Vis Sci,2016,57(1):265-275.
[4] Banerjee PJ,Davies NP. An Innocuous Adverse Effect of Routine Fundus Fluorescein Angiography[J]. JAMA Ophthalmol,2016,134(1):153624. 13 Verma A,Shackhs.
[5] Tomiyasu T,Hirahara S,Nozaki M,et al. Evaluation of Diabetic Retinopathy with Ultra-wide Field Fluorescein Angiography[J]. Nippon Ganka Gakkai Zasshi,2015,119(11):807-811.
[6] Yu S,Lu J,Cao D,et al. The Role of Optical Coherence Tomography Angiography in Fundus Vascular Abnormalities[J]. BMC Ophthalmol,2016(16):107.
[7] Teussink MM,Breukink MB,van Grinsven MJ,et al. OCT Angiography Compared to Fluorescein and Indocyanine Green Angiography in Chronic Central Serous Chorioretinopathy[J]. Invest Ophthalmol Vis Sci,2015,56(9):5229-5237.
[8] Rosas-Romero R,Martínez-Carballido J,Hernández-Capistrán J,et al. A Method to Assist in the Diagnosis of Early Diabetic Retinopathy:image processing applied to detection of microaneurysms in fundus images[J]. Comput Med Imaging Graph,2015,44:41-53.
[9] Chidambara L,Jayadev C,Mangalesh S,et al. Correlation of Spectraldomain Optical Coherence Tomography with Fundus Fluorescein Angiography in an Infant with Retinal Hamartomas[J]. Eur J Ophthalmol,2015,25(6):106-108.
[10] Nobre Cardoso J,Keane PA,Sim DA,et al. Systematic Evaluation of Optical Coherence Tomography Angiography in Retinal Vein Occlusion[J]. Am J Ophthalmol,2016,163:93-107.
[11] Hayreh SS,Zimmerman MB. Fundus Changes in Branch Retinal Arteriolar Occlusion[J]. Retina,2015,35(10):2060-2066.