摘要
目的分析糖尿病性视网膜病变(diabetic retinopathy,DR)患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)及血清C肽(C-PR)水平与眼底病变的相关性。方法选取2019年11月—2021年12月昆明医科大学附属昭通医院收治的90例DM患者作为研究对象,依据《糖尿病视网膜病变临床指南》将90例DM患者分为无DR组(n=45)和DR组(n=45)。同时选取同期在本院开展健康体检的45名健康人群设为对照组。比较3组FPG、HbA1c、血清C-PR水平。依据糖尿病视网膜病变分期将有DR组分为Ⅰ期(n=15)、Ⅱ期(n=9)、Ⅲ期(n=10)、Ⅳ期(n=11),并比较不同程度DR患者FPG、HbA1c、血清C-PR水平,采用Pearson相关分析FPG、HbA1c、血清C-PR水平和眼底病变的相关性,通过多因素Logistic回归分析方法分析影响增殖期DR发生的因素,采用ROC曲线评估模型诊断效能。结果与对照组和无DR组相比较,DR组FPG、HbA1c水平较高,血清C-PR水平较低,差异有统计学意义(P<0.05)。Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期DR患者的FPG、HbA1c、血清C-PR水平比较,差异有统计学意义(P<0.05)。Pearson相关分析显示,DR患者FPG、HbA1c水平与眼底病变严重程度程度呈正相关(r=0.629、0.583,P<0.05),血清C-PR水平与DR患者眼底病变严重程度程度呈负相关(r=-0.431,P<0.05)。多因素Logistic回归分析,FPG、HbA1c、血清C-PR水平是增殖期DR发生的独立影响因素。ROC曲线结果表明,上述3种指标联合检测增殖期DR的AUC为0.969,灵敏度、特异度分别为90.90%、81.81%。结论DR患者FPG、HbA1c、血清C-PR水平和眼底病变程度有紧密关联,眼底病变程度越严重,其FPG、HbA1c水平越高,血清C-PR水平越低,且FPG、HbA1c、血清C-PR 3种指标联合检测在评估增殖期DR的发生方面具有一定临床应用价值。
Objective To analyze the correlation between fasting plasma glucose(FPG),glycated hemoglobin(HbA1c)and serum C-peptide(C-PR)levels and fundus lesions in patients with diabetic retinopathy(DR).Methods 90 pa-tients with DM who were admitted to Zhaotong Hospital affiliated to Kunming Medical University from November 2019 to December 2021 were selected as research objects.According to the Clinical Guidelines for diabetes Retinopathy,90 patients with DM were divided into DR free group(n=45)and DR group(n=45).Meanwhile,45 healthy people who had physical examination in our hospital during the same period were selected as the control group.The levels of FPG,HbA1c and serum C-PR in 3 groups were compared.According to the stages of diabetic retinopathy,DR Group was divided into stageⅠ(n=15),stageⅡ(n=9),stageⅢ(n=10)and stageⅣ(n=11).FPG,HbA1c and serum C-PR lev-els of patients with different degrees of DR were compared.Results Compared with control group and DR frce Group,the levels of FPG and HbA1c in DR group were higher,and serum C-PR level was lower,the difference was statisti-cally significant(P<0.05).Comparison of FPG,HbA1c,and serum C-PR levels among DR patients in stages I,II,III,and IV,the difference was statistically significant(P<0.05).Pearson correlation analysis showed that FPG and HbA1c levels were positively correlated with the severity of fundus lesions in DR patients(r=0.629,0.583,P<0.05),and serum C-PR levels were negatively correlated with the severity of fundus lesions in DR patients(r=-0.431,P<0.05).Multi-variate Logistic regression analysis showed that FPG,HbA1c and serum C-PR levels were independent factors influ-encing the occurrence of DR in proliferative period.The ROC curve results indicate that the AUC for the combined di-agnosis of proliferative DR using the above three indicators was 0.969,with sensitivity and specificity of 90.90%and 81.81%,respectively.Conclusion The levels of FPG,HbA1c and serum C-PR in DR Patients were closely correlated with the degree of fundus lesions.The more ser
作者
唐婷
赵勋
李金萍
TANG Ting;ZHAO Xun;LI Jinping(Department of Endocrinology,Affiliated Zhaotong Hospital of Kunming Medical University,Zhaotong,Yunnan Prov-ince,657000 China;Department of Ophthalmology,Affiliated Zhaotong Hospital of Kunming Medical University,Zhaotong,Yunnan Province,657000 China;Department of Cardiovascular Medicine,Affiliated Zhaotong Hospital of)
出处
《糖尿病新世界》
2023年第9期173-177,共5页
Diabetes New World Magazine
