DR患者血清 C肽水平与视网膜病变发生发展的关系研究

目的探讨糖尿病视网膜病变（DR）患者血清C肽水平与视网膜病变发生发展的关系,以期为DR的临床治疗与预测评估提供依据。方法选取2010年3月—2012年10月十堰市郧西县人民医院收治的糖尿病患者360例为研究对象,根据DR病变程度,将糖尿病患者分为3组：A组为增殖性糖尿病视网膜病变（PDR）组,B组为非增生性糖尿病视网膜病变（NPDR）组,C组为无糖尿病视网膜病变（NDR）组。收集患者基本资料与血清生化指标,并进行组间比较。将具有明显统计学差异的因素进行Logistic回归分析。结果 A、B、C三组年龄、病程、体重指数（BMI）及收缩压（SBP）差异明显,有统计学意义（P〈0.05）,三组血清生化指标比较显示,高密度脂蛋白（HDL）和血清C肽（SCP）水平三组间差异明显,有统计学意义（P〈0.05）。对SCP进行组间分析表明,B组SCP水平明显低于A组,差异有统计学意义（P〈0.05）,C组SCP水平低于A组,亦低于B组,差异有统计学意义（P〈0.05）。DR患者风险因素Logistic回归分析发现,糖尿病病程与DR存在正相关性（P〈0.05）,SCP与DR的发生有明显负相关性（P〈0.05）。结论糖尿病患者血清C肽水平的降低是DR发展的重要危险因素,检测糖尿病患者血清中C肽的水平,能有效预防及预测DR的发生与发展。

Relationship between the development of retinopathy and serum C-peptide in DR patients

Objective To investigate the relationship between the development of retinopathy and serum C-peptide in DR patients, and to provide the basis for the clinical treatment and prediction of DR. Methods Three hundred and sixty diabetes patients were selected in Yunxi Metabolic Diseases Hospital between May ,2010 to October,2012 for the study. According to DR severity, the diabetic patients were divided into three groups. Group A was proliferative diabetic retinopathy （PDR） group, group B non-proliferative diabetic retinopa- thy （NPDR） group,group C no diabetic retinopathy （NDR） group. The basic information and serum biochemical indicators of patients were collected and compared between groups. The factors which had significantly statistical differences were analyzed with multivariate logistic regression. Results There were significant differences in age, duration of disease, body mass index （BMI） and systolic blood pressure （SBP） among the three groups（ P 〈 0.05 ）. There were no significant differences in gender ratio and diastolic blood pressure （DBP） （ P 〉 0.05）. In Comparison of the serum biochemical indicators among the three groups, there were no significant differences in fasting blood glucose （ FBG）, glycosylated hemoglobin （HbAle）, total cholesterol （ TC）, triglyceride （TG） and low-density lipoprotein （LDL） （P 〉 0.05）. There were significant differences in high-density lipoprotein （HDL） and serum C-peptide （SCP） （ P 〈 0.05 ）. SCP in group B was lower than that in group A, with statistically significant difference （P 〈 0.05）. SCP in group C was lower than that in group A, and was also lower than that in group B （ P 〈 0.05 ）. Risk factors were analyzed by logistic regression in DR patients. There were no significant correlations in age, BMI, SBP, HDL （ P 〉 0.05 ）. There was a positive correlation between duration and DR （ P 〈 0.05）. There was a significantly negative correlation between the occurrences of DR and