糖尿病视网膜病血清层粘蛋白的变化及意义

目的：探讨糖尿病微血管病变血管基膜和细胞外基质的关系。方法：放射免疫法检测86例2型糖尿病患者视网膜病变三个不同时期血清层粘蛋白（LN）的含量变化；无视网膜病变组（NDR）32组，单纯期视网膜病变组（BDR）24例，增殖期视网膜病变组（PDR）30例。同时检测正常对照组20名，分别与以上三组的结果比较。结果：血清LN水平在三组患者之间存在显著性差异，BDR和PDR高于NDR组和正常对照组，PDR组高于BDR组，差异均有显著性（P＜0．01）。血清LN水平与年龄和诊断病程均呈正相关（P＜0．05和P＜0．01），与空腹血糖和餐后血糖亦呈正相关（P＜0．01和P＜0．01）。结论L：血清LN含量变化能够反映微血管病变的严重程度，对糖尿病微血管病变的诊断和治疗、预后判断有较好的指导作用。

Significance of serum laminin levels in the patients with diabetic retinopathy

Objective:To study the relation between extracellular matrix and the basement membrane of type 2 diabetic microangiopathy.Methods:The changes of laminin(LN) levels in 86 cases of type 2 diabetic retinopathy at different stages were examined by radioimmunoassay.The 86 cases were divided into 3 groups,32 were in no signs of diabetic retinopathy group(NDR),24 in background diabetic retinopathy group(BDR),and 30 in proliferative diabetic retinopathy group(PDR).Results:The serum LN levels showed significant differences in 3 groups .A significant increase of serum LN levels was found in BDR and PDR group compared with NDR and normal control group( P <0.01).The level of serum LN was significantly higher than that of BDR( P <0.01).The serum LN levels in all cases were correlated with the patients age( P <0.05) and the duration of diabetes( P <0.01).The levels of serum LN also showed positive relation with the levels of fasting blood glucose( P <0.01) and the 1 hour postprandial glucose( P <0.01).Conclusions:Our study suggests that the changes of serum LN levels of the patients with diabetic microangiopathy can reflect the severity of diabetic microangiopathy,and plays an important role in diagnosis,treatment and prognosis assessment of diabetic retinopathy.