2型DR患者同型半胱氨酸和胱抑素C水平的变化及相关性研究

目的:探讨同型半胱氨酸(Hcy)与胱抑素C(Cystatin C)及超敏C反应蛋白(hs-CRP)在2型糖尿病视网膜病变(DR)发病机制中的改变及其相关性。方法:选择经诊断为2型糖尿病患者无视网膜病变组45例;背景期DR组42例;增殖期DR组46例。同时选择40例健康正常人做对照组。Hcy,CysC采用酶联免疫分析法、hs-CRP采用颗粒增强免疫比浊法进行检测。双变量相关分析采用直线相关分析。结果:患者各组胱抑素C及同型半胱氨酸、超敏C反应蛋白含量明显高于对照组P<0.01,组间有非常显著差异P<0.01,且随着病程的进展升高明显P<0.01。Hcy与Cystatin C水平均有一定增长趋势,且两指标呈正相关(无视网膜病变组r=0.675,背景期DR组r=0.823,增殖期DR组r=0.756,P<0.01)。结论:2型糖尿病视网膜病变患者血浆胱抑素C、同型半胱氨酸、超敏C反应蛋白含量远高于正常对照,表明检测各指标在2型糖尿病视网膜病变的早期诊断、治疗等方面有很重要的临床意义,联合检测可推断糖尿病视网膜病变的进程,更全面的评价早期糖尿病视网膜病变,为临床早期干预血同型半胱氨酸及胱抑素C等提供理论基础。

Contents changes and correlations between Hcy and Cystatin C in patients with diabetic retinopathy in type 2 diabetes mellitus

·AIM:To investigate the changes of homocysteine(Hcy),cystatin C and high-sensitivity C-reactive protein(hs-CRP)in patients with type 2 diabetic retinopathy(DR)and determine if any correlations exist among these factors.·METHODS:Patients with type 2 diabetes mellitus(DM)without DR group included 45 individuals.Type 2 DM with nonproliferative DR group consisted of 42 patients and type 2 DM with proliferative DR group was composed of 46 patients.The control group comprised 40 healthy human beings.ELISA was utilized to assay the contents of Hcy and cystatin C while hs-CRP was detected by immune turbidimetry.Linear correlation analysis was used in bivariate correlation analysis.·RESULTS:The contents of Hcy,cystatin C and hs-CRP of patients from the 3 groups were significantly higher than of those from the control group(P<0.01).There were significant differences among all the groups(P<0.01).And the contents of the three factors increased significantly with the severity of disease(P<0.01).Hcy and cystatin C contents showed an increasing trend,and positive correlation between the two factors was observed(patients with type 2 DM without DR group:r=0.675;type 2 DM with nonproliferative DR group:r=0.823;type 2 DM with proliferative DR group:r=0.756,P<0.01).·CONCLUSION:The blood plasma contents of Hcy,cystatin C and hs-CRP in patients with type 2 DR are far higher than control,which suggests that detecting of the three factors possesses clinical significance for early diagnosis and therapy in type 2 DR.Associated assay may contribute to speculate the disease severity and therefore get an all-around judgment.Our study provides theoretical basis to the clinical intervention of blood Hcy,cystatin C.·