系统性炎症相关指数预测糖尿病视网膜病变发生的临床价值

Clinical value of systemic inflammation related index in predicting the occurrence of diabetic retinopathy

目的研究系统性炎症相关指数在预测糖尿病视网膜病变(diabetic retinopathy,DR)发生的临床应用价值。方法本研究为回顾性研究,选取2022年1月至10月于三峡大学附属仁和医院行荧光素眼底血管造影(fundu fluorescence angiography,FFA)检查明确为DR的102例患者作为研究对象,选取同期行FFA检查无视网膜病变的单纯糖尿病患者98例作为对照组。收集所有患者一般临床资料及血常规、糖化血红蛋白、尿酸及血脂相关检验结果。比较两组间的系统性炎症指数(systemic inflammatory index,SII)、系统性炎症反应指数(systemic inflammatory response index,SIRI)、系统性炎症综合指数(aggregate index of systemic inflammation,AISI)以及其他检验指标,采用Logistic回归分析探索DR发生的危险因素,受试者工作特征(receiver operating characteristic,ROC)曲线计算相关指标预测DR的曲线下面积(area under curve,AUC)和最佳截断值。结果DR组的SII、SIRI、AISI均高于对照组,而血红蛋白(hemoglobin,HGB)低于对照组(P<0.05);高血压、高血脂、SII、SIRI、AISI均为DR发生的独立危险因素,而HGB为保护因素;SIRI联合高血压、高血脂以及HGB预测DR发生的ROC的AUC为0.789(95%CI:0.728~0.851,P<0.001),最佳截断值为0.566(敏感度为62.7%,特异性为81.6%)。结论高血压与高血脂是DR发生的独立危险因素,而HGB为DR发生的保护因素,系统性炎症相关指数SII、SIRI、AISI均能有效预测DR的发生,联合高血压、高血脂及HGB后预测效果更佳。

Objective To study the clinical value of systemic inflammation related index in predicting the occurrence of diabetic retinopathy(DR).Methods This study is a retrospective study.102 patients who were confirmed to be DR by fundu fluorescence angiography(FFA)examination in our hospital from January 2022 to October 2022 were selected as the study subjects,and 98 patients with simple diabetes who were blind to omental lesions by FFA examination at the same time were selected as the control group.The general clinical data and blood routine,glycosylated hemoglobin,uric acid and blood lipid of all patients were collected.The systemic inflammatory index(SII),systemic inflammatory response index(SIRI),aggregate index of systemic inflammation(AISI)and other test indicators were compared between the two groups.The risk factors of DR were explored by Logistic regression analysis.The area under the curve(AUC)and the best cutoff value of DR were predicted by the relevant indicators calculated from the subject's work characteristic(ROC)curve.Results SII,SIRI and AISI in DR group were higher than control group,while hemoglobin(HGB)was lower than control group(P<0.05);Hypertension,hyperlipidemia,SII,SIRI and AISI are independent risk factors for DR,while HGB is a protective facto;Combined with hypertension,hyperlipidemia and HGB,the area under ROC curve of SIRI is 0.789(95%CI:0.728-0.851,P<0.001),and the diagnostic cut-off value was 0.566(sensitivity 62.7%,specificity 81.6%).Conclusion Hypertension and hyperlipidemia are independent risk factors for DR,while HGB is a protective factor.Systemic inflammation index SII,SIRI and AISI can effectively predict the occurrence of DR,and the prediction effect is better when combined with related hypertension,hyperlipidemia and HGB.