摘要
目的探讨尿白蛋白在糖尿病性视网膜病变(dia-betic retinopathy,DR)不同临床分型阶段中的应用价值,了解尿白蛋白与DR病程的相关性,探讨它在DR中的临床应用价值,以期用于DR病情监测。方法前瞻性调查研究。散瞳眼底检查在糖尿病人群中测定96例存在视网膜病变患者(病例组)及144例尚未出现视网膜病变患者(对照组)的尿白蛋白水平。计量资料采用u检验,进行相关性分析,并应用受试者工作特征(receiver operating characteristic,ROC)曲线进行比较和分析。结果尿白蛋白水平在DR不同临床分型的组间差异有统计学意义(F=10.683,P=0.000)。DR不同临床分型的ROC曲线分析:在轻度非增殖性糖尿病性视网膜病变(nonproliferative diabetic retinopathy,NPDR)时期,尿白蛋白ROC曲线位于机会对角线以下,曲线下面积(area undercurve,AUC)仅为0.441;而在中、重度NPDR时期,当诊断界值为12.7mg/L(约登指数=0.440)时,尿白蛋白的AUC为0.742,特异度(specificity,SPE)为56.10%,灵敏度(sensitivity,SEN)为87.88%;在增殖性糖尿病性视网膜病变(proliferativediabetic retinopathy,PDR)时期,当诊断界值为45mg/L时(约登指数=0.503),其AUC为0.761,SPE为87.80%,SEN为62.50%。结论尿白蛋白的表达水平与DR程度相关,可以反映DR的发展情况,辅助临床对糖尿病性视网膜病变进行监测。
Objective To analyze the level of urinary albumin in type 2 diabetes mellitus patients and to evaluate the clinical application value for monitoring different clinical types of diabetic retinopathy （DR）. Methods This was a prospective study using fundus fluorescein angiography as a standard. The level of urinary albumin was measured in 240 cases with type 2 diabetes mellitus （96 cases with retinopathy and 144 cases without retinopathy as a control）, Measurement data were analyzed by u-test and evaluated by receiver operating characteristic （ROC） curve analysis. Results The expression of urinary albumin showed a significant difference in different stages of DR （F=10.683, P=0.000〈0.01）. The ROC curve showed that the urinary albumin curve was positioned under the chance diagonal in mild non-proliferative diabetic retinopathy （NPDR）; the under-curve area was only 0.441. On the other hand, for the level in moderate and severe NPDR, the curve was positioned in the top left corner, the under-curve area was 0.742, the cut-off point was 12.7 mg/L, the specificity was 56.10% and the sensitivity was 87,88%. In the PDR level, the under-curve area was 0.761, the cut-off point was 45 mg/L, the specificity was 87.80% and the sensitivity was 62.50%. Conclusion The level of urinary albumin may be correlated with different types of DR. Therefore, the detection of urinary albumin may be used to screen and monitor the high-risk group with diabetic retinopathy in type 2 diabetes mellitus.
出处
《眼视光学杂志》
2008年第4期262-265,共4页
Chinese Journal of Optometry & Ophthalmology
基金
上海市教育委员会基金资助项目(2005BZ03)
关键词
尿白蛋白
糖尿病性视网膜病变
病程
ROC曲线
urinary albumin
diabetic retinopathy
diabetescourse
receiver operating characteristic curve
