微循环学杂志
微循環學雜誌
미순배학잡지
CHINESE JOURNAL OF MICROCIRCULATION
2014年
4期
64-66,70
,共4页
沙敏%石冬敏%王亚南%徐慧丽
沙敏%石鼕敏%王亞南%徐慧麗
사민%석동민%왕아남%서혜려
糖尿病性视网膜病变%糖化白蛋白%糖化血红蛋白%诊断价值
糖尿病性視網膜病變%糖化白蛋白%糖化血紅蛋白%診斷價值
당뇨병성시망막병변%당화백단백%당화혈홍단백%진단개치
Diabetic retinopathy%Glycated albumin%Glycated hemoglobin%Diagnosis value
目的：分析血清糖化白蛋白(GA)水平升高对2型糖尿病(T2DM)视网膜病变(DR)患者的诊断效能。方法：T2DM患者120例,依据是否合并DR将其分为DR组(50例)和非DR组,即T2DM组(70例)。液态酶法测定血清 GA,液相色谱法测定全血 HbA1c,比较两组 GA和 HbA1c 水平差异及其对 DR诊断的敏感度、特异度、阳性似然比和阴阳性预测值,分析 GA 和 HbA1c 与 DR 危险性的关系。结果：DR 组 GA、HbA1c 水平(25.11±6.50%和9.38±1.77%)较T2DM组(21.21±4.50%和8.71±1.31%)明显升高(P<0.05)。GA和 HbA1c ROC曲线下面积最大值分别为0.68和0.61,对应的诊断DR的 cut off 值分别为24.00%和9.35%,GA诊断 DR灵敏度为62.00%,高于 HbA1c的38.00%(P<0.05),GA诊断DR的特异度、阴阳性预测值略优于 HbA1c,但差异无统计学意义(P>0.05)。GA诊断DR的阳性似然比为2.71,优于 HbA1c 的1.48。Logistic 回归分析,GA回归系数的 Waldχ2值为7.488(P<0.05),其致DR的危险因子(OR)为1.16；HbA1c 的 Waldχ2为0.226(P>0.05)。结论：DR患者 GA水平明显高于非DR患者,是DR 的危险因素；GA>24.00%可作为DR的诊断指征。
目的：分析血清糖化白蛋白(GA)水平升高對2型糖尿病(T2DM)視網膜病變(DR)患者的診斷效能。方法：T2DM患者120例,依據是否閤併DR將其分為DR組(50例)和非DR組,即T2DM組(70例)。液態酶法測定血清 GA,液相色譜法測定全血 HbA1c,比較兩組 GA和 HbA1c 水平差異及其對 DR診斷的敏感度、特異度、暘性似然比和陰暘性預測值,分析 GA 和 HbA1c 與 DR 危險性的關繫。結果：DR 組 GA、HbA1c 水平(25.11±6.50%和9.38±1.77%)較T2DM組(21.21±4.50%和8.71±1.31%)明顯升高(P<0.05)。GA和 HbA1c ROC麯線下麵積最大值分彆為0.68和0.61,對應的診斷DR的 cut off 值分彆為24.00%和9.35%,GA診斷 DR靈敏度為62.00%,高于 HbA1c的38.00%(P<0.05),GA診斷DR的特異度、陰暘性預測值略優于 HbA1c,但差異無統計學意義(P>0.05)。GA診斷DR的暘性似然比為2.71,優于 HbA1c 的1.48。Logistic 迴歸分析,GA迴歸繫數的 Waldχ2值為7.488(P<0.05),其緻DR的危險因子(OR)為1.16；HbA1c 的 Waldχ2為0.226(P>0.05)。結論：DR患者 GA水平明顯高于非DR患者,是DR 的危險因素；GA>24.00%可作為DR的診斷指徵。
목적：분석혈청당화백단백(GA)수평승고대2형당뇨병(T2DM)시망막병변(DR)환자적진단효능。방법：T2DM환자120례,의거시부합병DR장기분위DR조(50례)화비DR조,즉T2DM조(70례)。액태매법측정혈청 GA,액상색보법측정전혈 HbA1c,비교량조 GA화 HbA1c 수평차이급기대 DR진단적민감도、특이도、양성사연비화음양성예측치,분석 GA 화 HbA1c 여 DR 위험성적관계。결과：DR 조 GA、HbA1c 수평(25.11±6.50%화9.38±1.77%)교T2DM조(21.21±4.50%화8.71±1.31%)명현승고(P<0.05)。GA화 HbA1c ROC곡선하면적최대치분별위0.68화0.61,대응적진단DR적 cut off 치분별위24.00%화9.35%,GA진단 DR령민도위62.00%,고우 HbA1c적38.00%(P<0.05),GA진단DR적특이도、음양성예측치략우우 HbA1c,단차이무통계학의의(P>0.05)。GA진단DR적양성사연비위2.71,우우 HbA1c 적1.48。Logistic 회귀분석,GA회귀계수적 Waldχ2치위7.488(P<0.05),기치DR적위험인자(OR)위1.16；HbA1c 적 Waldχ2위0.226(P>0.05)。결론：DR환자 GA수평명현고우비DR환자,시DR 적위험인소；GA>24.00%가작위DR적진단지정。
Objective:To analyze the diagnosis effect of glycated albumin(GA)elevation in type 2 diabetic mellitus (T2DM)retinopathy (DR).Method:There were 120 cases of type 2 diabetes mellitus.DR group were 50 cases and non-DR group (T2DM)were 70 cases.Serum GA was detected by liquid enzymatic method.Whole blood glycated hemoglobin (HbA1c)was detected by HPLC.Comparing the difference of GA and HbA1c level and the sensitivity,specificity,positive likelihood ratio and predictive value in DR diagnosis.The relationship of HbA1c and DR danger risk were analyzed.Results:GA and HbA1c in DR group was 25.11±6.50% and 9.38±1.77%.GA and HbA1c in T2DM group was 21.21±4.50% and 8.71±1.31%.There was significant different between DR group and T2DM group (P<0.05).The ROC curve area of GA was 0.68 and the GA cut off value was 24.00%. The ROC curve area of HbA1c was 0.61 and the HbA1c cut off value was 9.35%.The sensitivity of GA in DR was 62.00%.It was higher than that of HbA1c 38.00%(P<0.05).Specificity,positive and negative predictive value of GA in DR were all a little bit higher than these of HbA1c in DR.But there is no statistically significant difference(P>0.05).The positive likelihood ratio of GA in DR diagnosis was 2.71.It was better than 1.48 of HbA1c.Waldχ2 value of GA regression coefficients was 7.488(P<0.05),OR was 1.16.Waldχ2 value of HbA1c was 0.226 (P>0.05).Conclusion:The GA level in DR patients of T2DM is obviously higher than that in non-DR patients.It is a related risk factor of DR.GA>24.00% can be used as diagnostic indicators of critical value of DR.
