ROC曲线评价空腹血糖与糖化血红蛋白对糖尿病视网膜病变风险评估.docVIP

ROC曲线评价空腹血糖与糖化血红蛋白对糖尿病视网膜病变风险评估 　　【摘要】 目的 探讨受试者工作特征曲线（ROC）评价空腹血糖（FBG）和糖化血红蛋白（HbA1c）在诊断糖尿病视网膜病变（DR）中的价值。方法 600例糖尿病患者作为此次报告的研究对象， 均进行FBG、HbA1c监测及眼底检查， 从600例患者中随机抽取DR患者180例作为A组， 视网膜正常患者182例作为B组， 应用ROC曲线评价FBG、HbA1c对DR的评估风险。结果 A组FBG、HbA1c水平均高于B组， 差异均具有统计学意义（P0.05）。仅考虑FBG作用， FBG在7.9 mmol/L可以作为预防DR的安全参考值。单独考虑HbA1c作用， HbA1c控制在7.7%～8.2%可作预防DR的安全参考值。 将FBG和HbA1c结合起来考虑， 当HbA1c9%时， FBG水平控制在8.2 mmol/L可作预防DR发生的安全参考值：当HbA1c≥9%时FBG水平控制在7.5 mmol/L可作为预防DR发生的安全参考值。结论 FBG联合HbA1c检测方法简便、快速、准确， 且影响因素少， 对DR筛查和预测性诊断具有重要意义， 应将二者结合起来考虑， 才能有效地预防DR的发生。 　　【关键词】 受试者工作特征曲线；血糖；糖化血红蛋白；糖尿病视网膜病变；风险评估 　　DOI：10.14163/j.cnki.11-5547/r.2017.16.019 　　Risk assessment of ROC curve for diabetic retinopathy by evaluation of fasting blood glucose and glycosylated hemoglobin LYU Xiu-lan， SU Wan-wen， LIN Qiao-ling. Guangzhou City Panyu Central Hospital， Guangzhou 511400， China 　　【Abstract】 Objective To explore the value of receiver operating characteristic （ROC） curve for evaluating of fasting blood glucose （FBG） and glycosylated hemoglobin （HbA1c） in diagnosis of diabetic retinopathy （DR）. Methods A total of 600 diabetic patients as study subjects all received FBG and HbA1c monitoring and fundus examination. There were 180 DR patients as group A， and 182 normal retina patients as group B. ROC curve was applied to evaluate FBG and HbA1c for assessment risk of DR. Results Group A had higher FBG and HbA1c level than group B， and the difference had statistical significance （P0.05）. FBG as 7.9 mmol/L can be taken as security reference in prediction of DR by only considering effect of FBG， and HbA1c controlled 7.7%～8.2% can be taken as security reference in prediction of DR by only considering effect of HbA1c. By considering of FBG and HbA1c， FBG controlled as 8.2 mmol/L can be taken as security reference in prediction of DR when HbA1c9%， and FBG controlled as 7.5 mmol/L can be taken as security reference in prediction of DR when HbA1c ≥9%. Conclusion Combined detection of FBG and HbA1c is simple， rapid， accurate