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目的分析2型糖尿病视网膜病变(DR)的特点,探讨2型糖尿病患者血清胱抑素C(Cys-C)和高敏C反应蛋白(hs-CRP)的水平与DR的相关性。方法选择325例2型糖尿病患者进行眼底检查或眼底荧光造影,根据2002年国际分级标准将其分为5期,即无明显视网膜病变(1期),轻度非增殖性糖尿病视网膜病变(2期),中度非增殖性糖尿病视网膜病变(3期),重度非增殖性糖尿病视网膜病变(4期),增殖性糖尿病视网膜病变(5期)。记录病程,检测糖化血红蛋白(HbA1c)、hs-CRP、Cys-C、24h尿白蛋白定量(24h-UAE),分析DR各组的特点及相关因素。结果在纳入的病例中,DR的总患病率为47%;与1期相比,2、3、4、5各期的病程,HbA1c,hs-CRP,Cys-C,24h-UAE均显著升高(P<0.05),且依次性升高(P均<0.05);多元回归分析显示,Cys-C、hs-CRP分别是DR患病率及其严重程度的独立危险因素,分别与2型糖尿病患者的患病病程、HbA1c、24h-UAE呈正相关。结论 DR及其病情严重程度与Cys-C、hs-CRP密切相关,Cys-C、hs-CRP有可能成为预测DR发生发展的生物学指标。
Objective To analyze the characteristics of type 2 diabetic retinopathy (DR) and investigate the correlation between serum levels of Cystatin C (Cys-C) and high-sensitivity C-reactive protein (hs-CRP) and DR in type 2 diabetic patients. Methods A total of 325 patients with type 2 diabetes mellitus underwent fundus examination or fundus fluorescein angiography. According to the international classification standards in 2002, they were divided into 5 stages: no obvious retinopathy (stage 1), mild non-proliferative diabetic retinopathy ), Moderate non-proliferative diabetic retinopathy (3), severe non-proliferative diabetic retinopathy (4), proliferative diabetic retinopathy (5). The course of disease was recorded. HbA1c, hs-CRP, Cys-C and 24-h urinary albumin were measured 24hours to analyze the characteristics and related factors of each group. Results Among the included cases, the overall prevalence of DR was 47%. Compared with the first phase, the course of HbA1c, hs-CRP, Cys-C and 24h-UAE were significant (P <0.05). The multiple regression analysis showed that Cys-C and hs-CRP were independent risk factors for the prevalence of DR and its severity respectively The prevalence of HbA1c and 24h-UAE in type 2 diabetes patients was positively correlated. Conclusions The severity of DR and its severity are closely related to Cys-C and hs-CRP. Cys-C and hs-CRP may be biological predictors of DR.