应用ROC曲线分析血清标志物联合检测对早期糖尿病视网膜病变诊断价值  

Value of combined detection of serum markers in early diabetic retinopathy using ROC curve

作　　者：包塔娜[1] 潘焕峰[1] 齐月[1] 郝丽[1] Bao Tana;Pan Huanfeng;Qi Yue;Hao Li(Department of Endocrinology~ Jilin people＇s Hospital~ Jilin~ 132001~ China)

机构地区：[1]吉林市人民医院内分泌科,吉林吉林132001

出　　处：《当代医学》2018年第29期38-41,共4页Contemporary Medicine

摘　　要：目的探讨联合检测胱抑素C(Cys-C)、视黄醇结合蛋白4(RBP4)、同型半胱氨酸(Hcy)在早期糖尿病视网膜病变的诊断价值。方法选取糖尿病视网膜病变患者110例,根据糖尿病视网膜病变分级标准,分为DM组(糖尿病无视网膜病变组,n=30)、NPDR组(非增殖型糖尿病视网膜病变,n=50)、PDR组(增殖型糖尿病视网膜病变,n=30)。选取30例健康人作为对照组(NC组),同时检测4组研究对象Cys-C、RBP4、Hcy水平。结果 NPDR组、PDR组Cys-C、RBP4、Hcy水平明显高于DM组和NC组,差异有统计学意义(P<0.05);以眼底荧光造影作为金标准,NPDR组血清Cys-C、RBP4、Hcy联合诊断的灵敏度为90%、特异度为83.3%,均高于单项诊断(灵敏度分别为76%、76%、80%;特异度分别为53.3%、50%、66.7%)。ROC曲线显示联合诊断AUC值(0.967)高于Cys-C、RBP4、Hcy单项诊断(0.752、0.785、0.827)。结论血清中Cys-C、RBP4、Hcy对糖尿病视网膜病变早期诊断具有较高的价值,三项联合检测可提高诊断的准确性。Objective To explore the value of combined detection of serum markers in nonproliferative diabetic retinopathy using ROC curve. Methods Atotal of 110 cases of patients with diabetic retinopathy, according to the grading standard, divided into DM group （diabetes only, n 30）, group NPDR （nonproliferative diabetic retinopathy, n 50）, group PDR （proliferative diabetic retinopathy, n 30）. 30 healthy people were selected as the control group （group NC）, and the levels of Cys-C, RBP4 and Hcy were detected. Results Cys-C, RBP4 and Hcy levels were significantly high- er in NPDR and PDR group than that of DM and NC group, the difference was statistically significant （P〈0.05）. In the case of fluorescence fundus angiography as a gold standard, the sensitivity and the specificity of combined diagnosis of serum Cys-C, RBP4 and Hcy in group NPDR were 90% and 83.3%, which were higher than those of single diagnosis respectively （sensitivity 76%, 76%, 80%, specificity 53.3%, 50%, 66.7%）. The ROC curve showed that the combined diagnostic AUC value （0.967） was higher than that of Cys-C, RBP4, and Hcy respectively （0.752, 0.785, 0.827）. Conclusion Cys-C, RBP4 and Hcy in serum of diabetic retinopathy have certain value in early diagnosis of diabetic retinopathy, but combined diag- nosis of the three serum markers can improve the diagnostic accuracy.

关 键 词：糖尿病视网膜病变 胱抑素C 视黄醇结合蛋白4 高同型半胱氨酸 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]