血清Midkine、TBIL水平联合检测对糖尿病视网膜病变患者诊断效能的影响

Influence of Combined Detection of Serum Midkine and TBIL Levels in Diagnostic Efficacy of Diabetic Retinopathy

目的探讨血清中期因子(MK)、总胆红素(TBIL)联合检测对糖尿病视网膜病变(DR)的诊断效能,明确其在DR诊断中的应用价值。方法收集2014年7月~2016年12月在笔者医院就诊的215例2型糖尿病(T2DM)患者的临床资料,其中糖尿病无视网膜病变(NDR)79例,非增生性糖尿病视网膜病变(NPDR)81例,增生性糖尿病视网膜病变(PDR)55例;另选取同期健康体检者70例作为对照组。检测4组人群血清MK、TBIL表达水平,并对各项指标与DR的关系进行Person相关分析和Logistic回归分析,同时对Midkine、TBIL在DR中的诊断效能进行评估。结果 4组研究对象血清MK、TBIL表达水平比较,差异有统计学意义(P<0.05);其中MK水平在正常对照组、NDR组、NPDR组、PDR组患者中依次升高,而TBIL水平在各组中依次下降。MK与DR发生呈正相关(r=0.779,P=0.005),TBIL与DR发生呈负相关(r=-0.657,P=0.012);且两者均是DR发生的独立影响因素(OR=2.257、0.681,P<0.05);MK与TBIL联合检测诊断DR的敏感度明显高于各指标单独检测(P<0.05)。结论血清MK和TBIL表达水平均与DR的发生及疾病严重程度密切相关,其联合检测对DR具有较高的诊断效能。

Objective To explore the diagnostic efficacy of combined detection of serum midkine （MK） and total bilirubin （TBIL） levels of diabetic retinopathy（DR）, and determine the value in diagnosis of DR. Methods Clinical data of 215 cases of patients with type 2 diabetes mellitus （T2DM） treated in our hospital from July 2014 to December 2016 were collected, and diabetes mellitus without retinal lesions （NDR） in 79 cases, non-proliferative diabetic retinopathy （NPDR） in 81 cases, proliferative diabetic retinopathy （PDR） in 55 cases. Another 70 cases of physical examination persons in the same period were as the control group. Serum MK and TBIL levels were detected in the four groups, and the relationship between indexes and DR was done by Person correlation analysis and Logistic regression analysis, and diagnostic efficacy of Midkine and TBIL was evaluated in DR. Results Serum MK and TBIL levels were compared between the four groups, with statistically significant differences （P〈0.05）. MK level increased in normal control group, NDR group, NPDR group and PDR group, while TBIL levels decreased in each group. MK was positively correlated with DR （r=0.779, P=0.005）, and TBIL was negatively correlated with DR （r=-0.657, P=0.012）, and both were independent factors influencing DR （OR=2.257, 0.681, P〈0.05）. The sensitivity of combined detection of MK and TBIL in diagnosis of DR was higher than that of each index detected separately （P〈0.05）. Conclusion Serum MK and TBIL levels are closely related to the occurrence of DR and severity of the disease, and the combined detection has high diagnostic efficacy for DR.