毛细血管渗漏指数对2型糖尿病病人视网膜病变病情评估的作用  

Role of capillary leakage index in the evaluation of retinopathy in type 2 diabetic patients

作　　者：张丽丽 朱光[1] 崔淑敏 余伟 穆蕾 李新[1] ZHANG Lili;ZHU Guang;CUI Shumin;YU Wei;MU Lei;LI Xin(Department of Ophthalmology,The Second People′s Hospital of Bengbu,Bengbu Anhui 233000,China)

机构地区：[1]安徽省蚌埠市第二人民医院眼科,233000

出　　处：《蚌埠医学院学报》2024年第11期1443-1446,共4页Journal of Bengbu Medical College

基　　金：安徽省卫生健康科研项目(AHWJ2022c021)。

摘　　要：目的:探讨毛细血管渗漏指数对2型糖尿病病人视网膜病变病情评估的作用。方法:选取134例糖尿病视网膜病变(DR)病人作为研究对象,根据临床严重程度将病人分为非增殖性糖尿病视网膜病变(NPDR)组70例和增殖性糖尿病视网膜病变(PDR)组64例。收集病人一般资料、C反应蛋白(CRP)、血清白蛋白(ALB)、糖化血红蛋白、毛细血管渗漏指数(CLI)、黄斑中心凹处视网膜的厚度(CMT)和黄斑区视网膜容积(MRV)。采用Pearson相关分析评价CLI与CMT和MRV的相关性,采用logistic回归分析评价PDR发生的危险因素。结果:2组病人年龄、性别、收缩压、ALB、糖化血红蛋白水平差异均无统计学意义(P>0.05);PDR组病人CRP、CLI、CMT和MRV均明显高于NPDR组(P<0.01)。Pearson相关分析显示,DR病人CLI与CMT及MRV均呈明显正相关关系(r=0.847、0.762,P<0.01)。ROC曲线分析显示,CLI预测PDR病人的AUC为0.851(95%CI:0.781~0.921),敏感度为85.9%,特异度为82.9%。多因素logistic回归分析表明,CLI、CMT、MRV及CRP均为PDR发生的危险因素(P<0.05~P<0.01)。结论:CLI与DR病人视网膜病变的严重程度相关,可以作为早期预测PDR发生的临床指标,值得推广应用。Objective:To explore the role of capillary leakage index in the evaluation of retinopathy in patients with type 2 diabetes mellitus.Methods:The clinical data of 134 diabetic retinopathy(DR)patients were retrospectively analyzed.According to the clinical severity,the DR patients were divided into the non-proliferative diabetic retinopathy(NPDR)group(n=70)and proliferative diabetic retinopathy(PDR)group(n=64).The general data,C-reactive protein(CRP),serum albumin(ALB),hemoglobin A1c,capillary leakage index(CLI),central macular thickness(CMT)and macular retinal volume(MRV)were collected.The Pearson correlation analysis was used to evaluate the correlation between CLI,CMT and MRV,and the logistic regression analysis was used to evaluate the risk factors of PDR.Results:There was no statsitical significance in the age,sex,systolic blood pressure and ALB between NPDR group and PDR group(P>0.05).The CRP,CLI,CMT and MRV in the PDR group were significantly higher than those in NPDR group(P<0.01).The results of Pearson correlation analysis showed that the CLI was significantly positively correlated with CMT and MRV in DR patients(r=0.847、0.762,P<0.01).The ROC curve analysis showed that the AUC predicted by CLI for PDR patients was 0.851(95%CI:0.781-0.921),the sensitivity was 85.9%,and the specificity was 82.9%.The results of multivariate logistic regression analysis of PDR patients showed that the CLI,CMT,MRV and CRP were the independent risk factors of PDR patients(P<0.05 to P<0.01).Conclusions:The CLI is associated with the severity of retinopathy in DR patients,and can be used as a clinical indicator for early prediction of PDR,which is worthy of popularization and application.

关 键 词：2型糖尿病 非增殖性糖尿病视网膜病变 增殖性糖尿病视网膜病变 毛细血管渗漏指数 

分 类 号：R587.2[医药卫生—内分泌]