可溶性血管细胞黏附分子-1与2型糖尿病视网膜病变的相关性研究

目的研究2型糖尿病视网膜病变患者血清可溶性血管细胞黏附分子-1（sVCAM-1）水平的变化与糖尿病病程、视网膜病变程度、糖化血红蛋白、胰岛索、血糖及血脂之间的相关性。方法选取2型糖尿病不伴视网膜病变患者[无视网膜病变组（NDR）]20例、2型糖尿病伴背景型视网膜病变患者[背景型视网膜病变组（BDrt）]20例、2型糖尿病伴增殖型视网膜病变患者[增殖型视网膜病变组（PDR）]20例和健康体检（健康组）20例作为健康对照组。应用酶联免疫吸附法（ELISA）测定各组受试者血清sVCAM-1水平，微柱法测定HbAle，放免法测定空腹INS，同时测定FBG、血脂等，并收集糖尿病患者的病程、糖化血红蛋白、胰岛素、直糖、血脂资料，采用单因素方差分析、SNK-q检验和Pearson相关分析比较各组间sVCAM-1水平，sVCAM-1水平与各代谢指标间的相关性。结果PDR组、BDR组和NDR组患者的血清中sVCAM-1的浓度明显增高，与健康对照组比较差异均有统计学意义（均P〈0．001）；PDR组患者血清sVCAM-1的增高较BDR组、NDR组增高明显，差异均有统计学意义（均P〈0．001）；BDR组与NDR组患者血清sVCAM-1浓度相比较差异均无统计学意义（P〉0．05）。糖尿病患者血清sVCAM．1与病程呈正相关（r=0．338，P〈0．05），与HbAlc、FBG、CHO、TG、LDL、空腹INS均无相关关系。结论糖尿病视网膜病变不同时期血清sVCAM-1水平有不同程度的增高，提示sVCAM-1在视网膜病变的发生发展中起重要作用，并可能成为监测视网膜病变病情变化的有效指标之一。

Study of Serum Soluble Vascular Cell Adhesion Molecule-1 Level in Type 2 Diabetic Patients with Diabetic Retinopathy

Objective To study the change and the correlation of serum soluble vascular cell adhesion molecuh-1(sVCAM-1)level with diabetic retinopathy in type 2 diabetic patients.Methods 60 type 2 diabetic patients were selected for the study through the examination of ophthalmoscope and/or fundus fluorescence angiography by ophthalmologist.Diabetic patients were divided into three main groups:No signs of diabetic retinopathy(NDR)(n=20);Background DR(BDR)(n=20)Proliferative DR(PDR)(n=20).Healthy individuals matching sex and age of the patients were used as controls(n=20);Serum sVCAM-1 level was measured by ELISA,compared in diabetes without DR,with BDR,with PDR.These levels were compared with those of 20 controls.Results The serum level of sVCAM-1 in the DM patients with PDR or BDR and those without DR were significantly higher than those in healthy controls(all P＜0.001);Serum level of sVCAM-1 in PDR groups were higherthan those in DM patients with BDR or patients without DR(all P＜0.001);There was no difference between the patients with BDR and those without DR (P＞0.05).(4)In the DM patients,there was a positive correlation between serum sVCAM-1 and the course of diseases(r=0.338,P＜0.05),but no relationship with HbA1C,FBG,CHO,TG,LDL and INS.Conclusion Increased serum level of sVCAM-1 in different stage of DR patients suggested that they hagbe play an important role in the development of DR,and may assess the severity of diabetic retinopathy.The measuremem of serum sVCAM-1 levels in type 2 diabetic patients could be clinically useful for early diagnosis or treatment of diabetic retinopathy.