摘要
目的探讨糖尿病视网膜病变（DR）分期与尿微量蛋白定量及糖化血红蛋白（HbA1c）水平的关系。方法收集双眼分期相同的DR患者150例．除外伴糖尿病肾病以外的其他肾病病史者。其中男性74例，女性76例；年龄36～81岁，平均58．9岁；DRI期15例，Ⅱ期15例，Ⅲ期30例，Ⅳ期48例，期33例，Ⅵ期9例。纳入患者进行尿微量蛋白定量及HbA1c检测，尿微量蛋白定量包括4项，即尿微量白蛋白（mA1b）、免疫球蛋白G（IgG）、α1微球蛋白（α1-MG）、转铁蛋白（TRF）。将合并后的DR分期（Ⅰ-Ⅱ期，Ⅲ-Ⅳ期，Ⅴ-Ⅵ期）作为自变量，指标异常优势（Odds）为因变量，建立Logistic回归方程，分析DR合并分期与检验指标异常的关系。以常规DR分期为自变量，各指标检测数值为因变量，建立多重线性回归方程，分析DR分期与各指标数值结果的关系。结果Logistic回归结果显示，合并后的DR分期对于尿微量蛋白及糖化血红蛋白正常与否均有明显影响（P〈0．001），DRⅠ～Ⅱ期患者各指标的异常比例较低，DRⅢ-Ⅳ期的指标异常优势高于DRI～Ⅱ期，至少在6倍以上，DRⅤ～Ⅵ期的优势进一步升高，优势比（OR）陡然升至174或以上。多重线性回归结果显示，DR分期对尿微量蛋白各指标数值及HbA1c数值均存在影响（P〈0．001），其影响程度整体上随DR分期的进展依次增加。在体现DR分期与尿微量蛋白数值关系的4个回归方程中，有统计学意义的偏相关系数对应DRV期、Ⅵ期，而在DR分期与HbA1c关系的回归方程中．有统计学意义的偏相关系数对应DRⅢ～Ⅵ期。结论DRⅢ—Ⅳ期开始．尿微量蛋白定量4项及HbA1c异常的可能性开始明显增加，并随分期的进展增长迅速；DRⅢ期可以看作各指标异常的阈值分期。
OBJECTIVE To study the correlation between stages of diabetic retinopathy （DR） and concentration of urinary microprotein and glycosylated hemoglobin. METHODS A total of 150 cases whose both eyes were in the same stage of diabetic retinopathy were screened. Patients with history of kidney diseases except for diabetic nephropathy were excluded. Among them, 74 were male, 76 cases were female; their age ranged from 36 to 81 years old and 58.9 in average; for stages： 15 cases were in DR stage Ⅰ , 15 cases in stage Ⅱ ,30 cases in stage m ,4s cas- es in stage 1V ,33 cases in stage V and 9 cases in stage VI. Urinary microprotein and HbAlc were detected for all？ included？patients and urinary microprotein was detected in four indexes ：urine microalbumin （mAlb） ,immunoglobulinG（IgG） ,al microglobulin（cdMG） ,and transferrin （TRF）. Using Combined DR stages （ Ⅰ -Ⅱ, Ⅲ-Ⅳ, Ⅴ-Ⅵ） as the independent variables, abnormal advantage （Odds） as the dependent variable, to establish logistic regression equation, and then analyzed relationship between DR consolidation stages and abnormal indexes. Using regular DR classification as independent variable, the indexes as the dependent variable, to establish multiple linear regression equation, and analyzed the relationship between DR stages and the indexes. RESULTS Logistic regression results showed that the combined DR classification had a significant effect on concentration of urinary microprotein and HbAlc （P〈0.001）. Abnormal ratio of indexes in DR Ⅰ - Ⅱwas low,abnormal ratio advantage （Odds） of DR Ⅲ-Ⅳ was higher than that of DR Ⅰ - Ⅱ. To be specific, at least more than 6 times. While advantage of DR Ⅴ - Ⅵ further increased whose odds ratio （OR） rose to 174 or more. The resuh of multiple linear regression showed that DR stage had effects on both urinary microprotein indexes and HbAlc （P〈0.001）,and in the whole,its influence increased with the progress of the stages. In the four regression equations who ref
作者
许超
宋剑涛
张远龙
XU Chao SONG Jiantao ZHANG Yuanlong(Eye Hospital, China Academy of Chinese Medical Sciences ,Beijing 100040, China)
出处
《中国中医眼科杂志》
2016年第4期257-262,共6页
China Journal of Chinese Ophthalmology
关键词
糖尿病视网膜病变
分期
尿微量蛋白定量
相关性
回归分析
diabetic retinopathy
stage
concentration of urinary microprotein
correlation
regression analysis
