糖尿病患者血清瘦素、内皮素水平与糖尿病视网膜病变不同分期的相关性研究

目的探讨血清瘦素、内皮素水平与糖尿病视网膜病变的关系。方法收集本院内分泌科住院的2型糖尿病患者80例，将其分为增殖性视网膜病变组23例，非增殖性视网膜病变组30例，糖尿病无视网膜病变组27例，另设健康对照者30例。采用放射免疫法测定血浆瘦素水平，采用酶联免疫吸附双抗体夹心法原理（ELISA）定量测定内皮素水平，并于生化检验室检验空腹血糖、餐后2h血糖、糖化血红蛋白、胆固醇、三酰甘油。结果病例组，包括增殖性视网膜病变组、非增殖性视网膜病变组、糖尿病无视网膜病变组与对照组血浆瘦素分别为（17．41±5．81）μg／L、（13．32±6．78）μg／L、（9．52±4．34）μg/L、（5．1-4-3．4）μg/L；血浆内皮素水平分别为（80．68±13．57）mg／L、（73．38±12．37）mg／L、（65．33±11．24）mg／L、（45．25±9．06）mg／L。各病例组与对照组比较差异均有统计学意义（P〈0．01）；各病例组组问比较差异均有统计学意义（P〈0．01）；血浆瘦素水平与年龄、空腹血糖、餐后2h血糖、糖化血红蛋白、胆固醇、三酰甘油等无相关。血浆瘦素水平与体重指数呈正相关（r=0．468，P〈0．01）。结论血浆瘦素、内皮素水平是2型糖尿病视网膜病变发病的一种独立危险因子，且随着病情的加重，血浆瘦素、内皮素水平逐渐增高。为糖尿病视网膜病变的早期干预治疗提供了新思路。

Study on the relationship between serum level of leptin, endothelin and different stages of diabetic retinopathy in type 2 diabetes patients

Objective To evaluate the relationship between serum levels of leptin, endothelin and diabetic retinopathy in type 2 diabetes patients. Methods Leptin, endothelia, FBG, PBG, HBA1C, CHOL, TG and other clinical characteristics were tested in 80 type2 diabetes patients and 30 control case. All diabetes patients were divided into three group: non-diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy(PDR) according to the examination results of fundus. Correlations between levels of serum leptin and other parameters were analyzed. Results Plasma level of leptin in the type 2 diabetes with PDR group(17.41±5.81)μg/L] were higher than that in control, NPDR and NDR group (P＜0.01). Plasma level of ET in the type 2 diabetes with PDR group(80.68±13.57)mg/L] were higher than that in control, NPDR and NDR group (P＜0.01). The serum leptin levels were positively correlated with BMI(r＝0.468,P＜0.01). Conclusions Serum leptin and endothelin levels were elevated in patient with diabetic retinopathy as diabetic retinopathy aggravated and serum level of leptin and endothelin raised.