泪液肿瘤坏死因子-α水平在糖尿病视网膜病变诊断中的意义

发布时间：2018-03-14 21:22

本文选题：糖尿病　切入点：糖尿病视网膜病变　出处：《中国老年学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的了解糖尿病视网膜病变(DR)患者泪液肿瘤坏死因子(TNF)-α水平及其与DR的关系,探讨以泪液TNF-α水平诊断DR的可行性。方法分层随机抽样选择石家庄市9个社区,居住5年以上,年龄≥45岁的社区居民,进行横断面流行病学问卷调查,以口服糖耐量试验根据1999年WHO糖尿病(DM)诊断标准确立新诊断DM者。对新诊断及既往诊断DM者,检测泪液TNF-α水平,依据眼底检查确立DR。采用受试者工作特征曲线(ROC)进行判断,得到以泪液TNF-α水平诊断DR的最佳切点,计算阳性似然比(+LR),阴性似然比(-LR),阳性预测值(+PV),阴性预测值(-PV)。结果泪液TNF-α水平在正常糖耐量(NGT)组为(0.76±0.24)pg/ml,糖尿病无视网膜病变(NDR)组为(5.86±2.21)pg/ml,DR组为(10.69±3.67)pg/ml,组间差异有统计学意义(P0.01)。血液TNF-α在NGT组为(6.80±3.73)pg/ml,NDR组为(21.44±9.16)pg/ml,DR组为(31.16±10.43)pg/ml,组间差异有统计学意义(P0.01)。泪液TNF-α水平与血液TNF-α水平存在正相关(R=0.795,P0.01)。通过绘制ROC曲线,得到泪液TNF-α水平诊断DR相关的临界点为9.07 pg/ml,约登指数为0.600,敏感性和特异性分别为66.5%和6.5%,曲线下面积为0.867(95%CI为0.832~0.901)。+LR 10.23,-LR 0.36,+PV为60.38%,-PV 54.53%。结论石家庄市社区中老年DR患者泪液IL-6水平明显增高。泪液TNF-α水平作为DR诊断手段,有可行性。
[Abstract]:Objective to investigate the level of TNF- 伪 in tears of patients with diabetic retinopathy and its relationship with Dr, and to explore the feasibility of diagnosing Dr with TNF- 伪 level in tears. A cross-sectional epidemiological questionnaire survey was conducted among community residents aged more than 45 years. According to the diagnostic criteria of WHO diabetes mellitus in 1999, the newly diagnosed DM patients were established by oral glucose tolerance test. The level of TNF- 伪 in tears was detected for the newly diagnosed and previously diagnosed DM patients. According to the ocular fundus examination, DR. using the operating characteristic curve (ROC) of the subjects to judge, the best cut point for the diagnosis of Dr with tear TNF- 伪 level was obtained. The calculated positive likelihood ratio (LRN), negative likelihood ratio (NLR) and positive predictive value (PVN) were 0.76 卤0.24 g / ml in normal glucose tolerance NGT group and 5.86 卤2.21 渭 g / ml in diabetic non-retinopathy group, respectively. The difference between the two groups was statistically significant. Blood TNF- 伪 in NGT group was 21.44 卤9.16 渭 g / ml, the difference was statistically significant (P 0.01). There was a positive correlation between blood TNF- 伪 level and blood TNF- 伪 level. By drawing ROC curve, there was a significant correlation between TNF- 伪 level and blood TNF- 伪 level. The critical point for DR-related diagnosis of tear TNF- 伪 level was 9.07 PG / ml, the Yorden index was 0.600, the sensitivity and specificity were 66.5% and 6.5, respectively. The area under the curve was 0.832 ~ 0.901.LR 10.23-LR 0.36PV was 60.38 -PV 54.53.Conclusion in Shijiazhuang community, the area of the elderly patients with Dr is 0.832 ~ 0.901, and the PV is 60.38-PV 54.53.Conclusion. The level of TNF- 伪 in tears was used as a diagnostic method for Dr. It is feasible.
【作者单位】：石家庄市第一医院内分泌科;石家庄市第三医院眼科;石家庄市第一医院干部老年病科;
【基金】：石家庄市科学技术研究与发展指导计划项目(No.121461173)
【分类号】：R587.2;R774.1

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