摘要
目的探讨血液指标等因素与2型糖尿病患者发生糖尿病视网膜病变(DR)的相关性。方法收集3000名2型糖尿病患者的临床资料,根据其有无DR分为DR组及非糖尿病视网膜病变(NDR)组,记录2组患者的基本信息、生化指标、凝血指标及其他相关检查指标等数据,通过独立样本t检验及x^2检验筛出其相关性因素,并对相关性因素进行二元Logistic回归分析,应用ROC曲线评价所建立模型及各因素的诊断效能。结果 (1)一般资料:NDR组患者年龄(t=5.930,P=0.000)高于DR组,而收缩压(t=-9.725,P=0.000)及舒张压(t=-6.959,P=0.000)均低于DR组,差异有统计学意义。(2)生化指标:①肝功能:NDR组患者谷丙转氨酶(t=7.018,P=0.000)、谷草转氨酶(t=6.217,P=0.000)、谷氨酰转移酶(t=6.046,P=0.000)、碱性磷酸酶(t=2.958,P=0.003)、总胆红素(t=5.697,P=0.000)、直接胆红素(t=4.987,P=0.000)、间接胆红素(t=4.842,P=0.000)、总蛋白(t=13.803,P=0.000)及球蛋白(t=3.974,P=0.000)指标均高于DR组,差异有统计学意义。②肾功能:NDR组患者血尿素(t=-12.144,P=0.000)、血清尿酸(t=-5.326,P=0.000)及血肌酐(t=-9.967,P=0.000)指标均低于DR组,差异有统计学意义。③血脂:NDR组患者低密度脂蛋白胆固醇(t=-5.700,P=0.000)、总胆固醇(t=-5.196,P=0.000)及乳酸脱氢酶(t=-2.816,P=0.005)指标均低于DR组患者,差异有统计学意义。④血糖:NDR组患者糖化血红蛋白(t=-11.381,P=0.000)及空腹血糖(t=-3.456,P=0.001)指标均低于DR组;而空腹C肽(t=4.274,P=0.000)及血红蛋白(t=11.086,P=0.000)均高于DR组,差异有统计学意义。(3)凝血相关检查:NDR组患者纤维蛋白原(t=-2.023,P=0.043)指标低于DR组;而凝血酶原时间(t=5.268,P=0.000)及部分活化凝血酶原时间(t=2.093,P=0.036)高于DR组,差异有统计学意义。(4)其他:NDR组患者血沉(t=-2.933,P=0.003)指标低于DR组;而红细胞比积测定(t=12.642,P=0.000)及C反应蛋白(t=5.669,P=0.000)高于DR组,差异有统计学意义。(5)二元Logistic回归分析得出低密度脂蛋白胆固醇、血尿素、血红蛋白、球蛋白、糖化血红蛋白是DR发生的危险因素;ROC曲线验证该模型诊断效能较高。结论低密度脂蛋白胆固醇、血尿素、球蛋白、血红蛋白、糖化血红蛋白是DR发生的独立危险因素,与DR的发生成正相关。综合以上指标所建立的模型可较好的预测DR的发生。
OBJECTIVE To investigate the correlation between blood indexes and diabetic retinopathy(DR)in patients with type II diabetes.METHODS The clinical datum of3000 patients with type II diabetes were collected, the patients were divided into DR group and non-DR(NDR) group according to the presence or absence of DR. The basic information of patients in both groups, biochemical indexes, blood coagulation indexes, and other related test indexes were recorded and analyzed by t test and chi-square test to sieve out the correlation factors, and the correlation factors was further analyzed by binary Logistic regression analysis. The ROC curve was used to evaluate the diagnosis and effectiveness of various factors and the established model. RESULTS(1) Demographic information: Age of patients in the DR group was higher than it in the NDR group(t=5.930, P=0.000). And systolic blood pressure and diastolic blood pressure were lower than those in the NDR group(t=-9.725, P=0.000;t =-6.959, P =0.000), and the differences were statistically significant.(2) Blood biochemical indicators:(1) Liver function: Indexes of glutamic-pyruvic transaminase, glutamic oxalacetic transaminase, glutamyltransferase,alkaline phosphatase, total bilirubin direct bilirubin, indirect bilirubin, total protein and globulin of patients in the DR group were all higher than those of DR group(t=7.018, P=0.000;t=6.217, P=0.000;t=6.046, P=0.000;t=2.958, P=0.003;t=5.697, P=0.000;t=4.987, P=0.000;t=4.842, P=0.000;t=13.803,P=0.000;t=3.974, P =0.000), and the differences were statistically significant.(2) Renal function: Indexes of blood urea, serum uric acid and serum creatinine of patients in NDR group were lower than those in DR group(t=-12.144, P=0.000;t=-5.326, P=0.000;t=-9.967, P=0.000), and the differences were statistically significant.(3) Blood fat: Indexes of low-density lipoprotein cholesterol, total cholesterol and lactic dehydrogenase of patients in NDR group were lower than those in DR group(t=-5.700, P=0.000;t=-5.196, P=0.000;t=-2.816, P=0.005), and the differences were statistically significant.(4) Blood sugar: Indexes of glycosylated hemoglobin and fasting blood-glucose of patients in NDR group were lower than those in DR group(t=-11.381, P=0.000;t=-3.456,P=0.001). Fasting c-peptide and hemoglobin were higher than those in DR group(t=4.274, P=0.000;t=11.086, P=0.000), and the differences were statistically significant.(3) Clotting check: indexes of fibrinogen of patients in NDR group was lower than it in DR group(t=-2.023, P=0.043). Prothrombin time and partial activation of prothrombin time were higher than those in DR group(t=5.268,P=0.000;t=2.093, P=0.036), and the differences were statistically significant.(4) Else checks: Indexes of erythrocyte sedimentation rate(ESR) of patients in NDR group was lower than it in DR group(t=-2.933, P=0.003) and hematocrit assay and C-reactive protein were higher than those in DR group(t=12.642, P=0.000;t=5.669, P=0.000), and the differences were statistically significant.(5) Binary Logistic regression analysis concluded that low-density lipoprotein cholesterol, blood urea, hemoglobin, globulin and glycosylated hemoglobin were risk factors for the occurrence of DR.The ROC curve verified the high diagnostic efficiency of the model. CONCLUSIONS Low density lipoprotein cholesterol, blood urea, globulin, hemoglobin and glycosylated hemoglobin were independent risk factors for the occurrence of DR and positively correlated with the occurrence of DR. The model combining the above factors may better predict the occurrence of DR.
作者
王超杰
刘甜甜
刘琪
赵小萱
霍云凤
陈晨
WANG Chaojie;LIU Tiantian;LIU Qi(Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,China)
出处
《中国中医眼科杂志》
2020年第8期548-553,共6页
China Journal of Chinese Ophthalmology
基金
黑龙江省卫生计生委科研课题(2018234)
黑龙江中医药大学研究生创新科研项目(2019yjscx051)。
