中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2012年
12期
1127-1130
,共4页
张靖东%蔡成平%魏迎凤%胡楠
張靖東%蔡成平%魏迎鳳%鬍楠
장정동%채성평%위영봉%호남
糖尿病/并发症%视网膜病变%血小板内皮细胞黏附分子-1%糖化血红蛋白
糖尿病/併髮癥%視網膜病變%血小闆內皮細胞黏附分子-1%糖化血紅蛋白
당뇨병/병발증%시망막병변%혈소판내피세포점부분자-1%당화혈홍단백
Diabetes/complication%Retinopathy%Platelet endothelial cell adhesion molecule-1%Glycated hemoglobin A1c
背景 研究糖尿病视网膜病变(DR)发生发展的相关危险因素对DR的预防有重要意义,血小板内皮细胞黏附分子-1(PECAM-1)是介导糖尿病患者血管病变发生的重要介质,但其作用机制仍有待进一步研究. 目的 探讨2型糖尿病患者血清中PECAM-1水平变化对DR发生及发展的影响.方法 收集在南通市第三人民医院内分泌科确诊的2型糖尿病患者共54例,根据检眼镜检查和荧光素眼底血管造影(FFA)结果,依据1987年中华医学会DR分期标准将患者分为无DR(NDR)组18例、非增生型糖尿病视网膜病变(NPDR)组20例和增生型糖尿病视网膜病变(PDR)组16例,并收集年龄和性别与患者相匹配的18名健康体检者作为正常对照组.收集患者外周血,用ELISA法检测患者血清中PECAM-1的质量浓度；用高效液相色谱法检测患者血清中糖化血红蛋白(HbA1c)含量；采用全自动生化分析仪检测患者的血糖水平；探讨DR患者PECAM-1质量浓度与HbA1c含量的关系,并将各组患者的检测结果进行比较. 结果 PDR组、NPDR组、NDR组和正常对照组患者血清中PECAM-1质量浓度分别为(10.907±2.792)、(7.024±2.377)、(5.231±1.816)和(3.817±1.045) μg/L,总体差异有统计学意义(F=12.630,P=0.002),PDR组患者血清PECAM-1质量浓度明显高于NPDR组、NDR组和正常对照组,差异均有统计学意义(P＜0.05).PDR组、NPDR组、NDR组和正常对照组患者血清HbA1c水平分别为(12.596±3.148)％、(9.118±3.356)％、(5.491±1.017)％和(4.992±0.725)％,总体比较差异有统计学意义(F=7.130,P=0.015),PDR组、NPDR组患者血清HbA1c水平显著高于NDR组和正常对照组,PDR组PECAM-1和HbA1c水平明显高于NPDR组和正常对照组,差异均有统计学意义(P＜0.05).PDR组、NPDR组、NDR组患者血清PECAM-1质量浓度与血清HbA1c水平间均呈显著正相关(r=0.799,P＜0.01；r=0.647,P＜0.01；r=0.685,P＜0.01).病程≥10年的PDR组与NPDR组糖尿病病程比较差异有统计学意义(P=0.023).结论 PECAM-1高表达是促进DR发生和发展的重要因素,与患者的高血糖状态密切相关,预防DR应以治疗糖尿病、控制血糖为主.
揹景 研究糖尿病視網膜病變(DR)髮生髮展的相關危險因素對DR的預防有重要意義,血小闆內皮細胞黏附分子-1(PECAM-1)是介導糖尿病患者血管病變髮生的重要介質,但其作用機製仍有待進一步研究. 目的 探討2型糖尿病患者血清中PECAM-1水平變化對DR髮生及髮展的影響.方法 收集在南通市第三人民醫院內分泌科確診的2型糖尿病患者共54例,根據檢眼鏡檢查和熒光素眼底血管造影(FFA)結果,依據1987年中華醫學會DR分期標準將患者分為無DR(NDR)組18例、非增生型糖尿病視網膜病變(NPDR)組20例和增生型糖尿病視網膜病變(PDR)組16例,併收集年齡和性彆與患者相匹配的18名健康體檢者作為正常對照組.收集患者外週血,用ELISA法檢測患者血清中PECAM-1的質量濃度；用高效液相色譜法檢測患者血清中糖化血紅蛋白(HbA1c)含量；採用全自動生化分析儀檢測患者的血糖水平；探討DR患者PECAM-1質量濃度與HbA1c含量的關繫,併將各組患者的檢測結果進行比較. 結果 PDR組、NPDR組、NDR組和正常對照組患者血清中PECAM-1質量濃度分彆為(10.907±2.792)、(7.024±2.377)、(5.231±1.816)和(3.817±1.045) μg/L,總體差異有統計學意義(F=12.630,P=0.002),PDR組患者血清PECAM-1質量濃度明顯高于NPDR組、NDR組和正常對照組,差異均有統計學意義(P＜0.05).PDR組、NPDR組、NDR組和正常對照組患者血清HbA1c水平分彆為(12.596±3.148)％、(9.118±3.356)％、(5.491±1.017)％和(4.992±0.725)％,總體比較差異有統計學意義(F=7.130,P=0.015),PDR組、NPDR組患者血清HbA1c水平顯著高于NDR組和正常對照組,PDR組PECAM-1和HbA1c水平明顯高于NPDR組和正常對照組,差異均有統計學意義(P＜0.05).PDR組、NPDR組、NDR組患者血清PECAM-1質量濃度與血清HbA1c水平間均呈顯著正相關(r=0.799,P＜0.01；r=0.647,P＜0.01；r=0.685,P＜0.01).病程≥10年的PDR組與NPDR組糖尿病病程比較差異有統計學意義(P=0.023).結論 PECAM-1高錶達是促進DR髮生和髮展的重要因素,與患者的高血糖狀態密切相關,預防DR應以治療糖尿病、控製血糖為主.
배경 연구당뇨병시망막병변(DR)발생발전적상관위험인소대DR적예방유중요의의,혈소판내피세포점부분자-1(PECAM-1)시개도당뇨병환자혈관병변발생적중요개질,단기작용궤제잉유대진일보연구. 목적 탐토2형당뇨병환자혈청중PECAM-1수평변화대DR발생급발전적영향.방법 수집재남통시제삼인민의원내분비과학진적2형당뇨병환자공54례,근거검안경검사화형광소안저혈관조영(FFA)결과,의거1987년중화의학회DR분기표준장환자분위무DR(NDR)조18례、비증생형당뇨병시망막병변(NPDR)조20례화증생형당뇨병시망막병변(PDR)조16례,병수집년령화성별여환자상필배적18명건강체검자작위정상대조조.수집환자외주혈,용ELISA법검측환자혈청중PECAM-1적질량농도；용고효액상색보법검측환자혈청중당화혈홍단백(HbA1c)함량；채용전자동생화분석의검측환자적혈당수평；탐토DR환자PECAM-1질량농도여HbA1c함량적관계,병장각조환자적검측결과진행비교. 결과 PDR조、NPDR조、NDR조화정상대조조환자혈청중PECAM-1질량농도분별위(10.907±2.792)、(7.024±2.377)、(5.231±1.816)화(3.817±1.045) μg/L,총체차이유통계학의의(F=12.630,P=0.002),PDR조환자혈청PECAM-1질량농도명현고우NPDR조、NDR조화정상대조조,차이균유통계학의의(P＜0.05).PDR조、NPDR조、NDR조화정상대조조환자혈청HbA1c수평분별위(12.596±3.148)％、(9.118±3.356)％、(5.491±1.017)％화(4.992±0.725)％,총체비교차이유통계학의의(F=7.130,P=0.015),PDR조、NPDR조환자혈청HbA1c수평현저고우NDR조화정상대조조,PDR조PECAM-1화HbA1c수평명현고우NPDR조화정상대조조,차이균유통계학의의(P＜0.05).PDR조、NPDR조、NDR조환자혈청PECAM-1질량농도여혈청HbA1c수평간균정현저정상관(r=0.799,P＜0.01；r=0.647,P＜0.01；r=0.685,P＜0.01).병정≥10년적PDR조여NPDR조당뇨병병정비교차이유통계학의의(P=0.023).결론 PECAM-1고표체시촉진DR발생화발전적중요인소,여환자적고혈당상태밀절상관,예방DR응이치료당뇨병、공제혈당위주.
Background To study diabetic retinopathy (DR) related risk factors is very important in the prevention of DR.Platelet endothelial cell adhesion molecule-1 (PECAM-1) is an important mediator that mediates high blood glucose-induced vascular diseases in diabetic patients.However,its mechanism is still below understood.Objective This clinical study was to investigate the effect of serum level changes of PECAM-1 on DR in type 2 diabetic patients.Methods Fifty-four patients with type 2 diabetes were enrolled from the endocrinology department of the Third People' s Hospital of Nantong City.Fundus examination was performed using the ophthalmoscope and fundus fluorescence angiography (FFA) on all the patients,and these patients were grouped as the non-DR (NDR)group (18 cases),non-proliferative DR(NPDR) group (20 cases) and proliferative DR group (PDR) (16 cases) based on the DR staging criterion of the Chinese Medical Association (1987 version).Eighteen age-and gender-matched normal subjects served as the normal control group.Peripheral blood was collected,and serum PECAM-1 levels were assayed using ELISA.Serum HbA1c levels were detected using the high performance liquid colorimetric(HPLC) method.The correlation of serum PECAM-1 level with serum HbA1c level was analyzed.All results were compared among the groups.Results The serum PECAM-1 levels were (10.907 ± 2.792),(7.024 ±2.377),(5.231 ± 1.816) and (3.817 ± 1.045) μg/L,respectively,in the PDR group,NPDR group,NDR group and normal control group,showing a significant difference among the 4 groups (F =12.630,P =0.02).Serum PECAM-1 content was significantly higher in the PDR group when compared with the NPDR group,NDR group and normal control group (P＜0.05).The serum HbA1c levels were (12.596±3.148)％,(9.118±3.356)％,(5.491±1.017)％ and (4.992 ± 0.725)％ in the PDR group,NPDR group,NDR group and normal control group,respectively,with a significant difference among these 4 groups (F =7.130,P =0.015),and those in the PDR group and NPDR group were significantly elevated in comparison with the NDR group and normal control group (P＜0.05).Significantly positive correlations were seen between serum PECAM-1 level and HbA1 c level in the PDR group,NPDR group and NDR group (r=0.799,P＜0.01 ;r =0.647,P＜0.01 ;r =0.685,P＜0.01).Significantly more patients with a disease course of ≥ 10 years were in the NPDR group in comparison with the PDR group (P =0.023).Conclusions Increase of serum PECAM-1 level is closely associated with blood glucose level,and it is an important factor in the pathogenesis and development of DR.These results imply that control of blood glucose is crucial for the prevention of DR in patient with type 2 diabetes.
