中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2011年
6期
439-443
,共5页
糖尿病视网膜病变%受试者曲线分析%判别分析%风险评估
糖尿病視網膜病變%受試者麯線分析%判彆分析%風險評估
당뇨병시망막병변%수시자곡선분석%판별분석%풍험평고
Diabetic retinopathy%Receiver operating characteristic analysis%Discriminant analysis%Risk assessment
目的 探讨利用受试者工作特征曲线(ROC)分析筛选有诊断价值的因子,构建判别函数对糖尿病人群进行视网膜病变(DR)的风险评估.方法 横断面研究.以2型糖尿病(DM)人群为研究对象,眼底荧光血管造影为分组金标准,收集对照组150例(无DR),病例组100例(DR).病例组又按照眼底病变分型标准分为早期非增殖性DR组(轻度NPDR组)33例、中重度非增殖性DR组(中重度NPDR组)50例、增殖性糖尿病性视网膜病变(PDR)组17例.对血浆内皮素(ET-1)、血管内皮生长因子(VEGF)、血镁、肾功能相关指标、胰岛功能相关指标、血液流变学指标、血脂等DR相关指标进行配对t检验及单因素方差分析和ROC筛选,制订判别模型.结果 病例组的年龄、DM病程、血浆ET-1、血镁、尿白蛋白、尿β2微球蛋白指数均大于对照组,而甘油三酯、C肽、VEGF指数则低于对照组,病例组3个亚组间血浆ET-1、尿白蛋白指数随着DR的进展而依次增长,而年龄、矫正视力等依次降低,余指标先增长后下降或先下降后上升,以上差异均具有统计学意义.ROC分析显示,轻度非增殖性DR组和增殖性DR组血浆ET-1诊断效力最高(AUC轻度NPDR=0.742,AUCPDR=0.857)；中、重度非增殖性DR组尿白蛋白诊断效力最高(AUC中重度NPDR=0.742).结合统计学分析和ROC分析筛选出四个指标(VEGF、尿白蛋白、ET-1、血浆黏度200)入选判别分析,建立判别公式,回代法验证早期非增殖性DR组回代符合率可达96.4％,中重度非增殖性DR组和增殖性DR组回代符合率达100％.结论 在DM人群中可以使用判别模型为DR发病风险评估提供参考.
目的 探討利用受試者工作特徵麯線(ROC)分析篩選有診斷價值的因子,構建判彆函數對糖尿病人群進行視網膜病變(DR)的風險評估.方法 橫斷麵研究.以2型糖尿病(DM)人群為研究對象,眼底熒光血管造影為分組金標準,收集對照組150例(無DR),病例組100例(DR).病例組又按照眼底病變分型標準分為早期非增殖性DR組(輕度NPDR組)33例、中重度非增殖性DR組(中重度NPDR組)50例、增殖性糖尿病性視網膜病變(PDR)組17例.對血漿內皮素(ET-1)、血管內皮生長因子(VEGF)、血鎂、腎功能相關指標、胰島功能相關指標、血液流變學指標、血脂等DR相關指標進行配對t檢驗及單因素方差分析和ROC篩選,製訂判彆模型.結果 病例組的年齡、DM病程、血漿ET-1、血鎂、尿白蛋白、尿β2微毬蛋白指數均大于對照組,而甘油三酯、C肽、VEGF指數則低于對照組,病例組3箇亞組間血漿ET-1、尿白蛋白指數隨著DR的進展而依次增長,而年齡、矯正視力等依次降低,餘指標先增長後下降或先下降後上升,以上差異均具有統計學意義.ROC分析顯示,輕度非增殖性DR組和增殖性DR組血漿ET-1診斷效力最高(AUC輕度NPDR=0.742,AUCPDR=0.857)；中、重度非增殖性DR組尿白蛋白診斷效力最高(AUC中重度NPDR=0.742).結閤統計學分析和ROC分析篩選齣四箇指標(VEGF、尿白蛋白、ET-1、血漿黏度200)入選判彆分析,建立判彆公式,迴代法驗證早期非增殖性DR組迴代符閤率可達96.4％,中重度非增殖性DR組和增殖性DR組迴代符閤率達100％.結論 在DM人群中可以使用判彆模型為DR髮病風險評估提供參攷.
목적 탐토이용수시자공작특정곡선(ROC)분석사선유진단개치적인자,구건판별함수대당뇨병인군진행시망막병변(DR)적풍험평고.방법 횡단면연구.이2형당뇨병(DM)인군위연구대상,안저형광혈관조영위분조금표준,수집대조조150례(무DR),병례조100례(DR).병례조우안조안저병변분형표준분위조기비증식성DR조(경도NPDR조)33례、중중도비증식성DR조(중중도NPDR조)50례、증식성당뇨병성시망막병변(PDR)조17례.대혈장내피소(ET-1)、혈관내피생장인자(VEGF)、혈미、신공능상관지표、이도공능상관지표、혈액류변학지표、혈지등DR상관지표진행배대t검험급단인소방차분석화ROC사선,제정판별모형.결과 병례조적년령、DM병정、혈장ET-1、혈미、뇨백단백、뇨β2미구단백지수균대우대조조,이감유삼지、C태、VEGF지수칙저우대조조,병례조3개아조간혈장ET-1、뇨백단백지수수착DR적진전이의차증장,이년령、교정시력등의차강저,여지표선증장후하강혹선하강후상승,이상차이균구유통계학의의.ROC분석현시,경도비증식성DR조화증식성DR조혈장ET-1진단효력최고(AUC경도NPDR=0.742,AUCPDR=0.857)；중、중도비증식성DR조뇨백단백진단효력최고(AUC중중도NPDR=0.742).결합통계학분석화ROC분석사선출사개지표(VEGF、뇨백단백、ET-1、혈장점도200)입선판별분석,건립판별공식,회대법험증조기비증식성DR조회대부합솔가체96.4％,중중도비증식성DR조화증식성DR조회대부합솔체100％.결론 재DM인군중가이사용판별모형위DR발병풍험평고제공삼고.
Objective To investigate the clinical application value in the risk assessment of diabetic retinopathy using a receiver operating characteristic curve and discriminant analysis.Methods This was a cross-sectional study.The outcomes of correlated clinical and biochemical examinations were obtained in 250 cases with type 2 diabetes mellitus (100 cases with retinopathy and 150 cases without retinopathy as the control).Standard measurements were obtained with an ophthalmoscope and fundus fluorescein angiography.A receiver operating characteristic (ROC) curve was used to assess their value in the diagnosis of diabetic retinopathy and formulate a diagnostic discrimination model with Bayes's discriminant analysis.The correlated indexes of diabetic retinopathy were endothelin-1,vascular endothelial growth factor,magnesium,correlation indexes from renal and pancreas function,hemorheology indexes,and blood fat.Results ROC analysis showed that the diagnostic reliability of ET-1 was the best indicator in the mild stages of NPDR and PDR (AUCmild NPDR=0.742,AUCPDR=0.857); the diagnostic reliability of urinary albumin was the best indicator in the moderate and severe stages of NPDR (AUCmoderate and severe NPDR=0.742). The samples rechecked by the model showed a coincidence rate of 96.4％ in the mild stage of NPDR,and 100％ in the moderate and severe stages of NPDR and PDR.Conclusion The diagnostic discrimination model may be used to screen and monitor the high-risk group with diabetic retinopathy in type 2 diabetes mellitus.
