受试者工作特征评价血浆内皮素与血镁在糖尿病视网膜病变中的应用价值

Evaluation of plasm endothelin-1 and magnesium in diabetic retinopathy using receiver operating characteristic curve

目的以受试者工作特征(receiver operating char-acteristic,ROC)分析糖尿病人群中血镁与血浆内皮素-1水平,探讨并比较2者在糖尿病视网膜病变(diabetic retinopa-thy,DR)中的应用价值,制定联合诊断试验以期确定DR高危人群。方法采用前瞻性调查研究。散瞳眼底检查在糖尿病人群中测定96例存在视网膜病变患者(病例组)及144例尚未出现视网膜病变患者(对照组)的血镁及血浆内皮素-1指标。计量资料采用t检验,应用ROC曲线进行比较和分析。结果在糖尿病人群中作为并发视网膜病变的血液学参考指标,血浆内皮素-1ROC曲线下面积为0.737,血镁ROC曲线下面积为0.633。应用平行试验后灵敏度为92·39%,特异度为25.00%;应用序列试验后灵敏度为52.39%,特异度为76.10%.结论血浆内皮素-1和血镁在糖尿病视网膜病变的发生和发展中起着重要作用,通过联合试验,可以帮助提高诊断的灵敏度或特异度,辅助临床早期诊断DR。

Objective To explore the clinical application value of plasm endothelin-1 and magnesium using receiver operating characteristic （ROC） curve in patients with diabetic retinopathy,and to find out the high risk patients with type 2 diabetes mellitus. Methods Prospective investigation was used. The levels of plasm endothelin-1 and magnesium were measured in 240 cases with type 2 diabetes mellitus （96 cases with retinopathy and 144 cases without retinopathy as control）. The diagnostic standard was identified by ocular fimdus examination and fimdus fluorescein angiography. ROC curve was used to assess their value in diagnosis of diabetic retinopathy. Resuits As the diadyramic criteria in the type 2 diabetes mellitus patients complicated with retinopathy, the under-curve area of plasm endothelin-1 were 0. 737, the under-curve area of magnesium were 0. 633. The positive rate could be elevated significantly in patients with diabetic retinopathy when plasm endothelin-1 and magnesium were simultaneously detected. Using the parallel test,the sensitivity was 92.39% ,the specificity was 25.00% ;Using the serial test,the sensitivity was 52.39% ,the specificity was 76.10%. Conclusion The endothelin-1 and magnesium play a important role in the development and progression of diabetic retinopathy. Therefore, the detection of endothelin-1 and magnesium may be used to screen the high-risk group with diabetic retinopathy in type 2 diabetes mellitus.