β2-MG、Hcy、Cys-C检测在2型糖尿病视网膜病变诊断中的价值

β2-MG、Hcy、Cys-C detection in the diagnosis of type 2 diabetic retinopathy

目的探讨血清β2微球蛋白(β2-MG)、同型半胱氨酸(Hcy)、胱抑素C(Cys-C)联合检测对2型糖尿病视网膜病变(DR)的诊断价值。方法收集本院2018年1月至2020年2月收治的2型糖尿病(T2DM)患者173例,根据眼底病变分组,NDR组(国际临床分级1期)T2DM无视网膜病变者61例,NPDR组(国际临床分级2~4期)非增殖期糖尿病视网膜病变者53例,PRD组(国际临床分级5期)增殖期糖尿病视网膜病变者59例。比较各组血清β2-MG、Hcy、Cys-C水平,Pearson法分析DR患者血清β2-MG、Hcy、Cys-C相关性,Logistic多元回归法分析DR危险因素,绘制ROC曲线。结果各组T2DM病程、SBP、HbA1C、β2-MG、Hcy、Cys-C等指标比较,PRD组>NPDR组>NDR组,差异有统计学意义(P<0.05)。血清β2-MG、Hcy、Cys-C与DR患者T2DM病程、SBP、HbA1C均呈正相关(P<0.05),且DR患者血清β2-MG、Hcy、Cys-C指标相关性分析亦均呈正相关(P<0.05)。Logistic多元回归分析,T2DM病程、SBP、HbA1C、β2-MG、Hcy、Cys-C为T2DM患者并发DR的独立危险因素(P<0.05)。DR患者β2-MG、Hcy、Cys-C及三项指标联检诊断曲线下面积(AUC)分别为0.762,0.735,0.887,0.935;3项指标联检诊断效能明显高于血清β2-MG、Hcy、Cys-C单项检测,差异有统计学意义(P<0.05)。结论血清β2-MG、Hcy、Cys-C均为DR危险因素,其指标水平均可反DR患者病情程度,且三项指标联检对DR诊断价值良好。

Objective To investigate the diagnostic value of combined detection of serumβ2 microglobulin(β2-MG),homocysteine(Hcy),cystatin C(Cys-C)for type 2 diabetic retinopathy(DR).Methods 173 patients with type 2 diabetes mellitus(T2DM)admitted in our hospital from January 2018 to February 2020 were grouped according to the condition of fundus lesions in T2DM patients.NDR group(international clinical grade 1)T2DM 61 patients without retinopathy,53 patients(international clinical grade 2~4)with non-proliferative diabetic retinopathy,and 59 patients with proliferative diabetic retinopathy in PRD group(international clinical grade 5).The serumβ2-MG、Hcy、Cys-C levels of each group were compared,the correlation DR serumβ2-MG、Hcy、Cys-C was analyzed by Pearson method,the risk factors were analyzed by multiple regression method,and the ROC curve was drawn.Results The T2DM disease course,SBP,HbA1C,β2-MG,Hcy,Cys-C and other indexes of each group were compared.The difference was statistically significant between PRD group>NPDR group>NDR group(P<0.05).Serumβ2-MG,Hcy,Cys-C were positively correlated with DR patients‘T2DM course,SBP,HbA1C(P<0.05),and DR patients’serumβ2-MG,Hcy,Cys-C index correlation analysis were also positively correlated(P<0.05).Logistic multiple regression analysis showed that the course of T2DM,SBP,HbA1C,β2-MG,Hcy,and Cys-C were independent risk factors for DR in patients with T2DM(P<0.05).After ROC curve analysis,the area under the diagnostic curve(AUC)ofβ2-MG,Hcy,Cys-C and three indicators of DR patients was 0.762,0.735,0.887 and 0.935 respectively.The diagnostic efficacy of the three indicators was significantly higher than that of serumβ2-MG,Hcy,Cys-C single test,the difference was statistically significant(P<0.05).Conclusion Serumβ2-MG,Hcy,Cys-C are DR risk factors,and their index levels can reflect the disease status of DR patients,and the joint detection of three indicators is of good value in the diagnosis of DR.