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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(P<0.05)。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HbA1c<9%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。
Objective To investigate the value of receiver operating characteristic curve (ROC) in the assessment of diabetic retinopathy (DR) and fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c). Methods Six hundred and sixty diabetic patients were enrolled in this study. FBG, HbA1c surveillance and fundus examination were performed. One hundred and sixty patients with DR were randomly selected as group A and 182 patients with normal retinal function as group B. The ROC curve Evaluation of FBG, HbA1c assessment of the risk of DR. Results The levels of FBG and HbA1c in group A were higher than those in group B, the differences were statistically significant (P <0.05). Considering only the role of FBG, FBG at 7.9 mmol / L can be used as a safety reference for the prevention of DR. HbA1c alone considered, HbA1c control 7.7% ~ 8.2% can be used as a safe reference to prevent DR. When combined with FBG and HbA1c, FBG levels should be controlled at 8.2 mmol / L at HbA1c <9%, a safe reference value for preventing the development of DR: when HbA1c ≥ 9%, FBG levels are controlled at 7.5 mmol / L as prophylaxis DR safety reference value occurred. Conclusion The detection of HbA1c by FBG combined with HbA1c is simple, rapid and accurate, and has few influencing factors. It is of great significance for the screening and predictive diagnosis of DR. Combining the two should be considered in order to effectively prevent the occurrence of DR.