摘要
目的探讨非增生型糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)患者循环胆红素水平变化及其预测价值。方法选取2020年5月至2021年12月佳木斯市中医医院收治的100例2型糖尿病患者为研究对象。根据患者人工智能眼底照相筛查情况,将患者分为视网膜病变组(n=41)和非视网膜病变组(n=59)。比较两组患者的循环胆红素指标[直接胆红素(direct bilirubin,DBIL)、间接胆红素(indirect bilirubin,IBIL)、总胆红素(total bilirubin,TBIL)]水平;采用Spearman相关性分析探讨循环胆红素与糖化血红蛋白(glycosylated hemoglobin,HbA1c)的关系;采用Logistic回归分析探讨循环胆红素与NPDR的风险关系;绘制受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)分析循环胆红素对NPDR发生的预测效能。结果视网膜病变组患者的糖尿病病程、HbA1c、尿蛋白/肌酐比值均显著高于非视网膜病变组(P<0.05),TBIL、DBIL、IBIL水平均显著低于非视网膜病变组(P<0.05);Spearman相关性分析结果显示,TBIL、DBIL、IBIL均与HbA1c呈负相关(r=-0.457、-0.420、-0.484,P<0.05);Logistic回归分析结果显示,HbA1c是发生NPDR的独立危险因素(P<0.05);TBIL、DBIL、IBIL均是发生NPDR的独立保护因素(P<0.05);ROC曲线显示,TBIL、DBIL、IBIL预测NPDR发生的曲线下面积(area under the curve,AUC)分别为0.722、0.661、0.825,三者联合预测NPDR发生的AUC为0.913(0.844~0.992)。结论NPDR患者的血清TBIL、DBIL、IBIL水平下降,其与HbA1c均呈负相关,三者联合检测对预测NPDR的发生具有一定价值。
Objective To investigate the changes of circulating bilirubin levels in patients with non-proliferative diabetic retinopathy(NPDR)and its predictive value.Methods A total of 100 patients with type 2 diabetes admitted to Jiamusi Traditional Chinese Medicine Hospital from May 2020 to December 2021 were selected as the research objects.Patients were divided into retinopathy group(n=41)and non-retinopathy group(n=59)according to the screening of artificial intelligence fundus photography.The levels of circulating bilirubin indicators[direct bilirubin(DBIL),indirect bilirubin(IBIL)and total bilirubin(TBIL)]were compared between the two groups.Spearman correlation analysis was used to investigate the relationship between circulating bilirubin and glycosylated hemoglobin(HbA1c).Logistic regression analysis was used to investigate the relationship between circulating bilirubin and risk of NPDR.Receiver operator characteristic(ROC)curve was drawn to analyze the predictive efficacy of circulating bilirubin on NPDR.Results The duration of diabetes,HbA1c and urinary albumin-creatinine ratio in retinopathy group were significantly higher than those in non-retinopathy group(P<0.05),and the levels of TBIL,DBIL and IBIL were significantly lower than those in non-retinopathy group(P<0.05).Spearman correlation analysis showed that TBIL,DBIL,IBIL were negatively correlated with HbA1c(r=-0.457,-0.420,-0.484,P<0.05).Logistic regression analysis showed that HbA1c was an independent risk factor for NPDR(P<0.05),TBIL,DBIL and IBIL were independent protective factors for NPDR(P<0.05).ROC curve showed that the area under the curve(AUC)of TBIL,DBIL and IBIL to predict the occurrence of NPDR were 0.722,0.661 and 0.825,respectively,and the AUC of TBIL,DBIL and IBIL to predict the occurrence of NPDR was 0.913(0.844-0.992).Conclusion The serum levels of TBIL,DBIL and IBIL in patients with NPDR are decreased,which are negatively correlated with HbA1c.The combined detection of TBIL,DBIL and IBIL has certain value in predicting the occurrence of
作者
郝振伟
HAO Zhenwei(Department of Laboratory,Jiamusi Traditional Chinese Medicine Hospital,Heilongjiang,Jiamusi 154002,China)
出处
《中国现代医生》
2022年第31期52-56,共5页
China Modern Doctor
