摘要
目的探讨2型非增殖性糖尿病视网膜病变（NPDR）的相关影响因素。方法选取本院2010年1月-2014年4月就诊的176例2型NPDR患者作为NPDR组,选取同期就诊的176例非糖尿病视网膜病变（NDR）患者作为NDR组,比较两组的相关指标,采用Logistic回归模型明确NPDR的独立危险因素,并利用分类回归树（CART）进一步探讨独立危险因素在NPDR早期诊断中的价值。结果两组的病程、BMI和Lp（a）水平比较,差异有统计学意义（P〈0.05）。Logistic回归分析显示,Lp（a）升高是2型NPDR发生的独立相关因子。ROC曲线显示,Lp（a）判别2型NPDR发生的最佳界点为352.36 mg/L,此时判别2型NPDR的灵敏度和特异度分别为85.79%和98.67%。CART模型预测分析结果显示,Lp（a）作为2型NPDR发生强有力的预测因子,当Lp（a）〉353 mg/L时,2型糖尿病患者发生NPDR的概率为100%;当Lp（a）≤353 mg/L时,2型糖尿病患者发生NPDR的概率仅为2.5%。结论 2型糖尿病患者病程、BMI及Lp（a）是NPDR的相关独立危险因素,通过检测以上指标对评价高危人群有一定的应用价值。
Objective To explore the related influence factor of type 2 non-proliferative diabetic retinopathy（NPDR）.Methods 176 cases of type 2 diabetes with NPDR from January 2010 to April 2014 in our hospital were selected as the NPDR group,176 cases of non-diabetic retinopathy（NDR） in the same period were selected as the NDR group,The related clinical index between two groups was compared.The independent risk factor of NPDR were defined by using Logistic model,classification and regression tree（CART） was used to further explore the value of independent risk factor in the early diagnosis of NPDR. Results There was significant difference in the course of disease,BMI and Lp（a） between the NPDR group and the NDR group（P〈0.05）.Logistic regression analysis showed that the increased Lp（a） had obvious relationship with NPDR.ROC curves showed that the best cutoff point of the occurrence of type 2 NPDR of Lp（a） identifying was 352.36 mg/L,the sensitivity and specificity of the discriminant 2 NPDR at this time was 85.79% and98.67% respectively.CART model predictive analysis results showed,as the strong predictor for the occurrence of type 2NPDR,when the level of Lp（a） was more than 353 mg/L,the incidence rate of type 2 diabetes with NPDR was 100%,but when the level of Lp（a） was less than or equal to 353 mg/L,the incidence rate of diabetes with type 2 NPDR was 2.5%.Conclusion Disease course,BMI and Lp（a） of type 2 diabetes are the independent risk factors of NPDR.By testing the above indicators for evaluation high-risk groups have certain application value.
出处
《中国当代医药》
2016年第9期12-14,18,共4页
China Modern Medicine
