血栓弹力图α角、k值在糖尿病视网膜病变早期诊断中的应用价值

Application value of angle α and k value of thrombelastogram in early diagnosis of diabetic retinopathy

目的探讨DR患者血栓弹力图中α角和k值的表达特点及临床意义。方法选取2017年8月至2019年3月于福建医科大学附属第二医院门诊和住院治疗的T2DM患者274例,分为增殖期DR(PDR组)74例,非增殖期DR(NPDR组)90例,单纯T2DM患者(T2DM组)110例,另选取同期本院健康体检人群110名为正常对照(NC)组,分别测定血浆α角、k值、纤维蛋白原(Fib)。结果PDR组Fib高于其余3组(P<0.05)。NPDR、PDR组α角高于NC、T2DM组,k值低于NC、T2DM组(P<0.05)。PDR组α角高于NPDR组,k值低于NPDR组(P<0.05)。Spearman相关分析显示,血浆α角与DR呈正相关(r=0.55,P<0.01);血浆k值与DR呈负相关(r=-0.62,P<0.01)。血浆α角和k值的最佳分界点鉴别有无DR的值分别为62.5 deg[敏感度64.1%,特异度87.8%,曲线下面积(AUC)=0.855,P<0.001]和1.8 min(敏感度77.8%,特异度81.7%,AUC=0.868,P<0.001)。结论α角、k值与DR密切相关,可有助于早期诊断DR。

ObjectivesTo investigate the characteristics and clinical significance of the angleαand k value of thrombelastogram in patients with diabetic retinopathy(DR).Methods 274 patients with type 2 diabetes mellitus(T2DM)were selected,including patients with proliferative DR(PDR group,n=74),non-proliferative DR(NPDR group,n=90)and 110 patients without DR(T2DM group,n=110).Healthy subjects were selected as normal control(NC group,n=110).Plasma angleα,K value and fibrinogen(Fib)were measured respectively.Results Fib was higher in PDR group than in other three groups(P<0.05).Angleαwas higher while k value was lower in NPDR and PDR group than in NC and T2DM group(P<0.05).Angleαwas higher and k value was lower in PDR group than in NPDR group(P<0.05).Spearman correlation analysis showed that plasma angleαlevel was positively correlated with DR(r=0.55,P<0.01).The level of plasma k was negatively correlated with DR(r=-0.62,P<0.01).The optimal cut-off points of plasma angleαand k value with or without DR were 62.5 deg(sensitivity 64.1%,specificity 87.8%,AUC=0.855,P<0.001)and 1.8 min(sensitivity 77.8%,specificity 81.7%,AUC=0.868,P<0.001).Conclusion Angleαand k value were closely related to DR,which is helpful in early diagnosis of DR.