糖尿病视网膜病变相关的生化指标的变化及其临床预测价值

Changes of biochemical indexes of diabetic retinopathy and its value for clinical prediction

目的检测与糖尿病视网膜病变相关的生化指标来评估和预测临床价值。方法选取2013年4月～2016年12月天津中医药大学第一附属医院收治的238例2型糖尿病患者，采用放射免疫法检测血浆ET-1，及常规的生物化学方法检测血镁、尿微量白蛋白、尿β2微球蛋白、C肽。结果与对照组相比，研究组患者C肽水平下降显著，血镁、血浆ET-1、尿微量白蛋白、尿β2微球蛋白的水平升高显著，差异均有统计学意义（P＜0.05）。针对轻度非增生型（NP）DR患者，检测血浆ET-1的水平，诊断准确度是最高的，AUC=0.724，Spe=69.00%，Sen=71.04%；针对中重度非增生型（NP）DR患者，检测尿微量白蛋白的水平，诊断准确度是最高的，AUC=0.734，Spe=55.98%，Sen=88.24%；针对增生型（P）DR患者，检测血浆ET-1的水平，诊断准确度是最高的，AUC=0.849，Spe=83.00%，Sen=84.97%。结论针对糖尿病患者，检测血镁、血浆ET-1、尿微量白蛋白的变化可以诊断糖尿病视网膜的病变，还能够评估和预测临床价值。

Objective To evaluate the biochemical markers associated with diabetic retinopathy and predict its clinical value.Methods238cases of patients with type2diabetes methods from April2013to December2016were as subject,using radioimmuno assay to detect plasma ET-1detection of magnesium,blood and conventional biochemical methods of urinary albumin,urine beta2microspheres protein,peptide C.Results Compared with the control group,C peptide level in the study group decreased significantly,serum magnesium,serum ET-1,urinary albumin,urine beta2microglobulin levels increased significantly,the differences were all significant(P<0.05).For mild non proliferative DR(NP)patients,the level of plasma ET-1,the diagnostic accuracy is the highest,AUC=0.724,Spe=69.00%,Sen=71.04%;for severe DR(NP)patients,the level of urinary albumin,the diagnosis accuracy is the highest,AUC=0.734,Spe=55.98%,Sen=88.24%;the proliferative DR(P)patients,the level of plasma ET-1,the diagnostic accuracy is the highest,AUC=0.849,Spe=83.00%,Sen=84.97%.Conclusion For patients with diabetes,serum magnesium,serum ET-1,urinary albumin changes can diagnose diabetic retinal lesions,but also can evaluate and predict the clinical value.