血清胱抑素C及同型半胱氨酸與2型糖尿病視網膜病變的相關性分析

閆宇梅

摘 要：目的 探討CysC與Hcy與2型糖尿病視網膜病變的相關性。方法 選取我院2017年1月～12月收治的2型糖尿病患者160例，根據眼底照相結果分為糖尿病視網膜病變組（DR組）和糖尿病無視網膜病變組（NDR組），每組80例，同時選取健康受試者80例作為對照組。觀察各組患者血糖、血脂、血清CysC及Hcy水平。結果 ①DR組和NDR組SBP、DBP、FBG、2hBG、TG、TC、LDL-C、BUN、SCr、HbA1C、CysC和Hcy水平均高于對照組，差異具有統(tǒng)計學意義（P<0.05）；DR組和NDR組HDL-C水平低于對照組，差異具有統(tǒng)計學意義（P<0.05）；DR組SBP、TG、SCr、CysC和Hcy水平高于NDR組，差異具有統(tǒng)計學意義（P<0.05）。②CysC與病程、TG、SCr、Hcy呈正相關（r=0.428、0.490、0.479、0.215，P<0.05），與BMI、SBP、LDL-C、FBG無明顯相關性。③Logistic多元回歸分析顯示：TG、SBP、CysC和Hcy為影響2型糖尿病視網膜病變發(fā)生的危險因素。結論 高CysC及Hcy水平是發(fā)生糖尿病視網膜病變的危險因素，CysC聯合Hcy檢測對2型糖尿病視網病變的診治有一定指導意義。

關鍵詞：糖尿病視網膜病變；血清胱抑素C；同型半胱氨酸；相關性

中圖分類號：R587.2 文獻標識碼：A DOI：10.3969/j.issn.1006-1959.2018.17.027

文章編號：1006-1959（2018）17-0089-03

Abstract：Objective To investigate the relationship between CysC and Hcy and type 2 diabetic retinopathy.Methods A total of 160 patients with type 2 diabetes admitted to our hospital from January to December 2017 were enrolled.According to the results of fundus photography，the patients were divided into diabetic retinopathy group（DR group）and diabetic non-retinopathy group（NDR group），80 cases in each group，and 80 healthy subjects were selected as the control group.Blood glucose，blood lipids，serum CysC and Hcy levels were observed in each group.Results ①The levels of SBP，DBP，FBG，2hBG，TG，TC，LDL-C，BUN，SCr，HbA1C，CysC and Hcy in DR group and NDR group were higher than those in the control group，the difference was statistically significant（P<0.05）；The HDL-C levels in the DR group and the NDR group were lower than those in the control group，the difference was statistically significant（P<0.05）；the levels of SBP，TG，SCr，CysC and Hcy in the DR group were higher than those in the NDR group，the difference was statistically significant（P<0.05）.②CysC was positively correlated with disease course，TG，SCr and Hcy（r=0.428，0.490，0.479，0.215，P<0.05），and had no significant correlation with BMI，SBP，LDL-C and FBG.③Logistic multiple regression analysis showed that TG，SBP，CysC and Hcy were risk factors for the development of type 2 diabetic retinopathy.Conclusion High CysC and Hcy levels are risk factors for diabetic retinopathy.CysC combined with Hcy detection has certain guiding significance for the diagnosis and treatment of type 2 diabetic retinopathy.

Key words：Diabetic retinopathy；Serum cystatin C；Homocysteine；Correlation

微血管病變（microangiopathy）是2型糖尿病患者最為常見且嚴重的慢性并發(fā)癥之一[1-3]，臨床上常以糖尿病視網膜病變（diabetic retinopathy，DR）、糖尿病腎病（diabetic nephropathy，DN）等為主要表現。研究發(fā)現，嚴重的糖尿病視網膜病變可導致失明[4]。研究表明，血清胱抑素C（CysC）是理想的反映腎小球濾過功能的內源性指標，在早期腎損傷診斷中敏感性較高[5]，血清CysC可作為預測2型糖尿病早期腎病的指標[6]。近年來研究證實，同型半胱氨酸（Hcy）是導致動脈粥樣硬化的獨立危險因素，其與糖尿病心腦血管并發(fā)癥的發(fā)生密切相關[7]。但兩者與糖尿病視網膜病變的相關性研究相對較少，本研究通過檢測糖尿病視網膜病變患者中血清CysC及Hcy水平，了解其與糖尿病視網膜病變的相關性，探討血清CysC及Hcy預測糖尿病視網膜病變的價值，為臨床防治糖尿病視網膜病變提供理論依據。

1資料與方法

1.1一般資料 選取晉煤集團總醫(yī)院2017年1月～12月收治的2型糖尿病患者160例，本研究經醫(yī)院倫理會批準。根據眼底照相結果將所有患者分為糖尿病伴視網膜病變組（DR組）和糖尿病無視網膜病變組（NDR組），每組80例。……