2型糖尿病视网膜病变与U-ALB及血Fb、Hb水平的相关性分析

目的 探讨2型糖尿病患者尿微量白蛋白(urine microalbuminuria,U-ALB)排出量及血纤维蛋白原(fibrinogen,Fb)、血红蛋白(hemoglobin,Hb)在糖尿病视网膜病变发生中的可能意义.方法 2010年1月至2014年9月我院收治的101例2型糖尿病患者,按照是否伴视网膜病变分为无合并症组(n=49)及合并视网膜病变组(n=52,其中单纯期38例,增殖期14例);健康体检者作为对照(n=50).151例受试者均接受临床指标体质指数(BMI)、空腹血糖、收缩压和舒张压等]检查,并检测U-ALB及血Fb、Hb水平.结果 2型糖尿病患者U-ALB高于正常受试者,且合并视网膜病变组高于无合并症组,差异均有统计学意义(P＜0.01);2型糖尿病患者血Fb水平高于正常受试者,且合并视网膜病变组高于无合并症组,差异均具有统计学意义(P＜0.01);正常受试者Hb水平高于2型糖尿病患者,且合并视网膜病变组低于无合并症组,差异均具有统计学意义(P＜0.01).与单纯期视网膜病变患者相比,增殖期视网膜病变患者U-ALB及血Fb、Hb变化趋势更明显(P＜0.01).结论 2型糖尿病患者存在U-ALB及血Fb、Hb水平的改变,且合并视网膜病变患者改变更明显.

Correlation of diabetic retinopathy with U-ALB and blood Fb, Hb levels in patients with type 2 diabetes mellitus

Objective To explore the clinical significance of U-ALB (urine microalbuminuria), Fb (fibrinogen) and Hb (hemoglobin) expression with type 2 diabetes mellitus (T2DM) patients combined with retinopathy. Methods From Jan. 2010 to Sep. 2014, 101 patients with type 2 diabetes were enrolled in this study. According to whether combined with retinopathy the patients were divided into 2 groups: non complication group (49 cases) and diabetic combined with retinopathy group (52 cases, 38 patients with non-proliferative DR and 12 cases with proliferative DR); in addition, 50 healthy subjects were enrolled as control group. All subjects underwent the examination of clinical index (BMI, fasting blood glucose, blood pressure, etc.) and detected the expression of urinary U-ALB and Fb/Hb in the plasma. Statistical analysis was performed for analysis. Results The level of U-ALB in urine from patients with type 2 diabetes was higher than that in healthy subjects, and in patients with DR complication U-ALB was significantly higher than that in without complication, the difference was statistically significant (all P<0.05). Fb expression in patients with type 2 diabetes was significantly higher than that in healthy subjects, and the elevated trend in combined DR group was more significant, the differences were statistically significant (all P<0.05). Hb level in healthy subjects was higher than that in patients with type 2 diabetes, and Hb expression in DR combined group decreased more, the differences were statistically significant (all P<0.05). Compared with the non-proliferative DR patients, the change of U-ALB and Fb/Hb was more obvious in patients with proliferative DR. The expression of U-ALB, Fb and Hb were positively related with TNF-a and APN expression in serum. Conclusions The expressions of U-ALB, Fb and Hb were correlated with type 2 diabetes mellitus and diabetic retinopathy.