摘要
目的:探究Hcy、HbA1c、UA水平及联合检测对糖尿病视网膜病变发生的预测价值研究。方法:选取在本院就诊的118例2型糖尿病(T2DM)患者,收治时间为2020年6月至2024年6月。所有患者在入院后1~2周内完成眼科检查,基于眼科检查结果,将118例患者分为两组:DR组(n=62)和NDR组(n=56)。检测两组患者的血清Hcy、HbA1c、UA水平,采用单因素分析比较两组各临床指标的差异,通过多因素Logistic回归分析评估Hcy、HbA1c、UA水平与DR发生的独立相关性,并利用受试者工作特征(ROC)曲线分析Hcy水平对DR的预测价值。结果:DR组患者的Hcy水平、眼压、HbA1c、UA明显高于NDR组(P<0.05)。多因素Logistic回归分析显示,Hcy、HbA1c、UA是糖尿病视网膜病变的影响因素(P<0.05)。ROC曲线分析表明,Hcy、HbA1c、UA联合对DR的预测价值较高,曲线下面积(AUC)为0.830(95%CI:0.750-0.893),均高于单独检测(Z/P=2.137/0.032、4.527/<0.001、2.879/0.004),其敏感度为90.32%,特异性为66.07%。结论:血清Hcy、HbA1c、UA水平升高与DR的发生相关,具有较高的预测价值,以上指标可作为DR潜在早期筛查指标,有助于临床风险分层和早期干预。
Objective:To explore the predictive value of Hcy,HbA1c,and UA levels and the combined detection of the occurrence of diabetic retinopathy(DR).Methods:A total of 118 patients with type 2 diabetes mellitus(T2DM)who were diagnosed in the hospital from June 2020 to June 2024 were selected.All patients completed an eye exam within 1-2 weeks of admission.Based on the results of ophthalmic examination,118 patients were divided into DR group(n=62)and NDR group(n=56).Serum Hcy,HbA1c,UA levels in the two groups were detected,and the differences in clinical indicators between two groups were compared with univariate analysis.The independent correlation between Hcy,HbA1c,UA level and DR occurrence was evaluated with multivariate Logistic regression analysis,and the predictive value of Hcy,HbA1c,UA level on DR was assessed by receiver operating characteristic(ROC)curve.Results:Hcy level,intraocular pressure,HbA1c,and UA in the DR group were higher than those in the NDR group(P<0.05).Multivariate Logistic regression analysis showed that Hcy,HbA1c,and UA were the influential factors of diabetic retinopathy(P<0.05).ROC curve analysis indicated that the combined detection of Hcy,HbA1c,and UA had a higher predictive value for DR,with an area under the curve(AUC)of 0.830(95%CI:0.750-0.893),which was higher than single detection(Z/P=2.137/0.032,4.527/<0.001,2.879/0.004).The sensitivity was 90.32%and the specificity was 66.07%.Conclusion:The elevated levels of serum Hcy,HbA1c and UA are correlated with the occurrence of DR and have high predictive value.The above indicators can be used as potential early screening indicators for DR,which is helpful for clinical risk stratification and early intervention.
作者
王超
董崇周
章结楼
明慧
WANG Chao;DONG Chongzhou;ZHANG Jielou(Tongling People's Hospital,Anhui Tongling 244000,China)
出处
《河北医学》
2025年第7期1164-1169,共6页
Hebei Medicine
基金
安徽省卫生健康科研项目,(编号:AHWJ2023BAc20076)。
