同型半胱氨酸和胆红素与糖尿病视网膜病变的关系

目的分析血浆同型半胱氨酸、血清胆红素水平与糖尿病视网膜病变发生之间的关系。方法选取2011年10月至2012年10月在我院内分泌科住院的2型糖尿病患者95例作为研究对象,分为糖尿病视网膜病变组（DR组）50例,糖尿病非视网膜病变组（NDR组）45例。测定两组血浆同型半胱氨酸和血清叶酸、维生素B12、总胆红素水平。采用SPSS 17.0软件进行统计学分析。结果 DR组血浆同型半胱氨酸水平（16.67μmol/L）高于NDR组（13.91μmol/L）,差异有统计学意义（P〈0.05）,叶酸水平（7.5μmol/L）低于NDR组（11.8μmol/L）,差异有统计学意义（P〈0.05）,两组间血清维生素B12水平差异无统计学意义（P=0.858）。DR组血清总胆红素水平（10.45μmol/L）低于NDR组（11.40μmol/L）,差异有统计学意义（P〈0.05）。结论高同型半胱氨酸血症可能是糖尿病视网膜病变发生的危险因素。血清胆红素对糖尿病视网膜病变的发生有一定的保护作用。

Association of the homocysteine and bilirubin with the diabetic retinopathy

Objective To analyze the association of the plasma homocysteine level and serum total bilirubin level with the occurrence of diabetic retinopathy. Methods Ninety five patients with type 2 diabetes mellitus （T2DM） form Oct. of 2011 to Oct. of 2012 served as the subjects, 95 subjects were divided into the diabetic retinopathy group （DR group, 50 cases） and non-diabetic retinopathy group （NDR group, 45 cases）. The levels of plasma homocysteine and serum folic acid, vitamin B-12, total hilirubin were measured in all subjects. SPSS 17.0 software was used to analyze the data. Results The level （16.7 ~mol/L） of plasma homocysteine in DR group was significantly higher than that （13.91 ;xmol/L） of NDR group （/＇〈0.05）. The level （7.5 tLmol/L） of serum folio acid in DR group was significantly lower than that （ 11.8 μmol/L） of NDR group （P〈0.05）, but there was no significant difference of serum vitamin B-12 between two groups （P〉0.05）. The level （10.45 μmol/L） of serum total bilirubin in DR group was significantly lower than that （11.40 μmol/L） of NDR group （P〈0.05）. Conclusion The hyperhomocysteinemia may be a risk factor for diabetic retinopathy. The serum total bilirubin may play a role in the protection from diabetic retinopathy in patients with T2DM to some extent.