糖尿病视网膜病变与血清Ⅳ胶原、层粘连蛋白的关系

目的 探讨糖尿病视网膜病变(DR)与血清IV胶原(IVC)、层粘连蛋白(LN)之间的关系。 方法 143例 2型糖尿病患者作为病例组,并依据视网膜病变情况分为三组:无视网膜病变组(NDR)58例,背景期视网膜病变组(BDR)47例,增殖期视网膜病变组(PDR)38例。同时设健康体检者55人为对照组。采用放射免疫法测其血清IVC、LN的含量。所有检测者均测定空腹血糖、糖化血红蛋白、血脂、尿白蛋白排泄率、体重指数,分析病例组血清IVC、LN水平与视网膜病变的关系。结果 (1)血清IV-C水平:三组糖尿病患者明显高于对照组(P<0.01)。病例组间比较,PDR组高于BDR组,BDR组高于NDR组,差异均有非常显著意义(P<0.01)。(2)血清LN水平:BDR组、PDR组高于对照组,差异均有非常显著意义(P<0.01),NDR组与对照组比较,增高不明显,无统计学意义(P>0.05)。病例组间比较,PDR组高于BDR组,BDR组高于NDR组,差异均有非常显著意义(P<0.01)。(3)Logistic多元回归分析显示,血清IVC、LN、病程是DR发病的独立风险因素。结论 血清IVC、LN与DR发生发展密切相关,联合检测血清IVC、LN水平,有助于估计DR病变程度及预后。

The relationship between diabetic retinopathy and the serum level of IV collagen and Laminin

Objective To investigate the relationship between the diabetic retinopathy and theserum component level of the IV collagen and laminin. Methods Based on the severity of the diabeticretinopathy, 143 cases of the diabetes patients (patient group) are divided into three groups: nodiabetic retinopathy group (NDR) with 58 cases, background diabetic retinopathy group (BDR) with 47cases, proliferate diabetic retinopathy group(PDR) with 38 cases. And, 55 healthy people are collectedas the control group (CR) as well. The serum level of IV collagen and Laminin are determined by Radio-immunoassay, and also, the level of fasting serum glucose, HbA1C, blood lipid, AER, BMI of each casesare determined ,to investigate the relationship between DR and them. Result (1) The serum IVC levelof the 3 patient groups (NDR, BDR, PDR) are obviously higher than that of the control group (p<0.01).Compared within the 3 patient groups, the serum IVC level of PDR group is much higher than that of BDRgroup, and the IVC level of BDR group is much higher than that of NDR group, and the difference betweenthe groups are significant (p<0.01). (2) The serum LN level of BDR group and PDR group is much higherthan that of the control group, the difference between the groups is significant (P<0.01), but the IVClevel between the NDR group and the control group is not significant differently (P>0.05). (3)Multivariate stepwise regression analysis shows that the serum IVC and LN level are the independent riskfactor of DR.Conclusion The serum IVC and LN level are closely related to DR. To combinativedetermination of IVC and LN can help to judge the disease development and the prognosis.