| 王梦珍,王可,万枕驰,等.系统免疫炎症指数与 2型糖尿病视网膜病变的相关性[J].安徽医药,2026,30(5):998-1003. |
| 系统免疫炎症指数与 2型糖尿病视网膜病变的相关性 |
| Correlation analysis of systemic immune-inflammation index with type 2 diabetic retinopathy |
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| DOI：10.3969/j.issn.1009-6469.2026.05.030 |
| 中文关键词: 糖尿病视网膜病变 2型糖尿病 系统免疫炎症指数 全身炎症反应指数 |
| 英文关键词: Diabetic retinopathy Type 2 diabetes mellitus Systemic immune-inflammation index Systemic inflammation re. sponse index |
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| 摘要点击次数: 233 |
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| 中文摘要: |
| 目的探讨系统免疫炎症指数( SII)、全身炎症反应指数( SIRI)与糖尿病视网膜病变( DR)的相关性。方法选取 2018年 3月至 2023年 10月就诊于徐州医科大学附属医院内分泌科的 2型糖尿病( T2DM)病人 461例，根据病人眼底照相结果分为单纯 T2DM组( n=226)与 DR组( n=＝235)。 DR组分为非增殖期视网膜病变组( NPDR)组 151例与增殖期视网膜病变组( PDR)组 84例。收集病人的一般资料和血液学指标，计算 SII、SIRI。分析 SII、SIRI在各组间的差异；受试者操作特征曲线( ROC曲线)评估各指标对 DR的诊断价值；多因素 logistic回归分析探讨 DR的危险因素。结果与 T2DM组比较， DR组高血压患病率(42.60%比 33.20%)、糖尿病病程［ 11.00(6.00，19.00)年比 3.00(0.30，9.25)年］、身体质量指数( BMI)［24.61(22.66，27.11)kg/m2比 25.71(23.48，27.76)kg/m2］、舒张压( DBP)［80(80，90)mmHg比 84(80，92)mmHg］、糖化血红蛋白( HbA1c)［9.10(7.30，10.70)%比 8.45(7.00，10.33)%］、空腹血糖( FBG)［7.77(5.86，11.27)mmol/L比 8.62(6.87，11.23)mmol/L］、谷丙转氨酶( ALT)［17(13，22)U/L比 19(14，29)U/L］、谷草转氨酶( AST)［16(14，20)U/L比 18(14，23)U/L］、总胆红素( TB)［9.40(6.40，12.30)μmol/L比 11.85(8.68，15.30)μmol/L］、胆碱酯酶( CHE)［8 884.0(7 738.0，10 380.0)U/L比 9 520.5(8 544.5，10 541.5)U/L］尿素氮( BUN)［6.21(5.11，8.10)mmol/L比 5.39(4.48，6.41)mmol/L］、肌酐( sCr)［63.00(51.00，82.00)μmol/L比 55.00(46.00， μmol/L］、胱抑素 C(Cys-C)、甘油三酯( TG)、高密度脂蛋白( HDL)、SII［513.13(383.80，701.46)×109/L比 362.87(281.27，473.82)×109/L］、 SIRI［0.82(0.59，1.13)×109/L比 0.57(0.42，0.81)］差异有统计学意义( P<0.05)。与 NPDR亚组比较， PDR亚组的糖尿病病程、 FBG、 ALT、TB、BUN、sCr、Cys-C、HDL、低密度脂蛋白( LDL)差异有统计学意义( P<0.05)。 Spearman相关性分析结果示 SII与 SBP、糖尿病病程、 BUN、Cr、Cys-C呈正相关( P<0.05)与 TG、AST、ALT、TB呈负相关( P<0.05)。 SIRI与年龄、糖尿病病程、 SBP、DBP、 BUN、sCr、UA、Cys-C呈正相关( P<0.05)，与 TCDL、TB、CHE呈负相关( P<0.05)。 logistic回归分析显示 SII是 DR发生的影响 62.25)因素。 ROC曲线显示 SII、糖尿病病程、 HbA1c、SII联合糖尿病病程诊断 DR的 ROC曲线下面积分别为 0.75、0.77、0.57、0.85。结论 SII是 DR的独立危险因素，临床上具有一定的诊断价值。 |
| 英文摘要: |
| Objective To investigate the relationship between systemic immune-inflammation index (SII), systemic inflammatory re. sponse index (SIRI) and diabetic retinopathy (DR).Methods A total of 461 patients with type 2 diabetes mellitus (T2DM) who weretreated in Department of Endocrinology of Affiliated Hospital of Xuzhou Medical University from March 2018 to October 2023 were en.rolled in this study. According to the results of fundus examination, the patients were divided into T2DM group (n=226) and DR group (n=235). DR group was further divided into non-proliferative retinopathy (NPDR) group (n=151) and proliferative retinopathy (PDR) group (n=84). General clinical data and biochemical indexes were collected, and SII and SIRI were calculated. The differences betweenSII and SIRI among each group were analyzed. The receiver operating characteristic curve(ROC curve) was used to evaluate the diag.nostic value of each index for DR. Multivariate logistic regression analysis was conducted to explore the risk factors of DR. Results Hypertension (42.60% vs. 33.20%), diabetes duration [11.00 (6.00, 19.00) year vs. 3.00 (0.30, 9.25) year], body mass index (BMI) [24.61 (22.66, 27.11) kg/m2 vs. 25.71 (23.48, 27.76) kg/m2], diastolic blood pressure (DBP) [80 (80, 90) mmHg vs. 84 (80, 92) mmHg], glycated hemoglobin (HbA1c) [9.10 (7.30, 10.70)% vs. 8.45 (7.00, 10.33) %], fasting blood glucose (FBG) [7.77 (5.86,11.27) mmol/L vs. 8.62 (6.87, 11.23) mmol/L], glutamic oxalacetic transaminase (AST) [16(14, 20) U/L vs. 18(14, 23) U/L], glutamicpyruvic transaminase (ALT) [17(13,22)U/L vs. 19(14,29)U/L], total bilirubin (TB) [9.40 (6.40, 12.30) μmol/L vs. 11.85 (8.68, 15.30) μmol/L], cholinesterase (CHE) [8 884.0 (7 738.0, 10 380.0) U/L vs. 9 520.5(8 544.5, 10 541.5) U/L], urea nitrogen (BUN) [6.21(5.11, 8.10) mmol/L vs. 5.39 (4.48, 6.41) mmol/L], serum creatinine (sCr) [63.00 (51.00, 82.00) μmol/L vs. 55.00 (46.00, 62.25) μmol/L], cystatin C (Cys-C), triglyceride (TG), high-density lipoprotein (HDL), SII [513.13 (383.80, 701.46) ×109/L vs. 362.87 (281.27, 473.82) ×109/L] and SIRI [0.82 (0.59, 1.13)×109/L vs. 0.57 (0.42, 0.81)×109/L] in the T2DM and DR group were different, and the differences were statistically significant (P< 0.05). Compared with NPDR group, diabetes duration, FBG, ALT, TB, BUN, sCr, Cys-C, HDL and low-density lipoprotein (LDL) in PDR group were different, and the differences were statistically significant (P<0.05). Spearman correlation analysis showed that SII was positively correlated with SBP, duration of diabetes, BUN, Cr, and Cys-C(P<0.05), and negatively correlated with TG, AST, ALT, and TB (P<0.05). SIRI was positively correlated with age, duration of diabetes, SBP, DBP, BUN, sCr, UA, and Cys-C(P<0.05), and nega. tively correlated with TC, LDL, TB, and CHE (P<0.05). Logistic regression analysis showed that SII was the influencing factors for theoccurrence of DR. The areas under ROC curve predicted by SII, diabetes duration, HbA1c and SII combined with diabetes duration indiagnosing DR were 0.75, 0.77, 0.57, 0.85, respectively.Conclusion SII is an independent risk factor for DR and has certain diagnos. tic value in clinical practice. |
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