CAJ | 학술논문

目的：了解石家庄市社区居民中老年糖尿病视网膜病变（DR）患者血液 HbA1c 水平与泪液 IL-6水平间的关系、泪液IL-6水平与DR严重程度间的关系。方法：分层随机抽样选择石家庄市9个社区，居住5年以上，年龄≥45岁的社区居民，进行横断面流行病学问卷调查，行 OGTT 试验据1999年 WHO 糖尿病诊断标准确立新诊断糖尿病者。对新诊断及既往诊断糖尿病者，检测血清 HbA1c、血清 IL-6、泪液 IL-6水平。依眼底检查评估DR 严重程度，受试人群分为正常组（NGT）、糖尿病非视网膜病变组（NDR）、糖尿病非增殖期视网膜病变组（NPDR）、糖尿病增殖期视网膜病变组（PDR）。血清IL-6与泪液IL-6之间，血液HbA1c与泪液IL-6之间分别进行相关分析。结果：泪液IL-6水平在NGT 组为（3．10±1．25） pg／mL，NDR 组为（10．25±3．22） pg／mL，NPDR 组为（16．80±5．76） pg／mL，PDR 组为（25．11±5．20） pg／mL。各组间存在差异（P ＜0．01），两两比较存在统计学差异（P ＜0．01、P ＜0．05、P ＜0．05）。血液 IL-6在 NGT 组为（88．04±17．06） pg／mL，NDR组为（126．38±20．73） pg／mL，NPDR 组为（239．83±40．33） pg／mL，PDR 组为（268．36±27．72） pg／mL。各组间存在差异（P ＜0．01），两两比较各组间两两不同（P ＜0．01）。泪液IL-6水平与血液IL-6水平存在正相关（R ＝0．756，P ＜0．01）；泪液IL-6水平与血液HbA1c 水平存在正相关（R ＝0．338，P ＜0．01）。结论：石家庄市社区中老年2型糖尿病患者泪液IL-6水平较正常老年人增高，DR 变患者随视网膜病变严重程度增加，其泪液IL-6水平逐渐增高。泪液IL-6水平、血清IL-6水平以及血液HbA1c水平可一定程度上反应DR严重程度。
목적：료해석가장시사구거민중노년당뇨병시망막병변（DR）환자혈액 HbA1c 수평여루액 IL-6수평간적관계、루액IL-6수평여DR엄중정도간적관계。방법：분층수궤추양선택석가장시9개사구，거주5년이상，년령≥45세적사구거민，진행횡단면류행병학문권조사，행 OGTT 시험거1999년 WHO 당뇨병진단표준학립신진단당뇨병자。대신진단급기왕진단당뇨병자，검측혈청 HbA1c、혈청 IL-6、루액 IL-6수평。의안저검사평고DR 엄중정도，수시인군분위정상조（NGT）、당뇨병비시망막병변조（NDR）、당뇨병비증식기시망막병변조（NPDR）、당뇨병증식기시망막병변조（PDR）。혈청IL-6여루액IL-6지간，혈액HbA1c여루액IL-6지간분별진행상관분석。결과：루액IL-6수평재NGT 조위（3．10±1．25） pg／mL，NDR 조위（10．25±3．22） pg／mL，NPDR 조위（16．80±5．76） pg／mL，PDR 조위（25．11±5．20） pg／mL。각조간존재차이（P ＜0．01），량량비교존재통계학차이（P ＜0．01、P ＜0．05、P ＜0．05）。혈액 IL-6재 NGT 조위（88．04±17．06） pg／mL，NDR조위（126．38±20．73） pg／mL，NPDR 조위（239．83±40．33） pg／mL，PDR 조위（268．36±27．72） pg／mL。각조간존재차이（P ＜0．01），량량비교각조간량량불동（P ＜0．01）。루액IL-6수평여혈액IL-6수평존재정상관（R ＝0．756，P ＜0．01）；루액IL-6수평여혈액HbA1c 수평존재정상관（R ＝0．338，P ＜0．01）。결론：석가장시사구중노년2형당뇨병환자루액IL-6수평교정상노년인증고，DR 변환자수시망막병변엄중정도증가，기루액IL-6수평축점증고。루액IL-6수평、혈청IL-6수평이급혈액HbA1c수평가일정정도상반응DR엄중정도。
Objective To investigate the relationship between HbA1c in blood and IL-6 in tear fluid of the elderly patients with diabetic retinopathy ( DR ) in Shijiazhuang urban communities , and the relationship between IL-6 in tear fluid and the severity of DR. Methods The elderly people who lived more than 5 years , older than ≥45 year old. in nine urban communities of Shijiazhuang were stratified randomly sampled and received cross-sectional epidemiology questionnaire survey and OGTT. A total of 1 447 subjects (509 males and 938 females) were included. Each participant underwent epidemiological surveys and oral glucose tolerance test (OGTT), according to the 1999 WHO diabetes mellitus (DM) diagnostic criteria established. For patients who were newly or previously diagnosed as DM. HbA1c level, tear fluid IL-6 and serum IL-6 tested.The severity of DR was evaluated by fundus examination, the people were divided into normal group(NGT), non-diabetic retinopathy ( NDR ) , non-proliferative diabetic retinopathy ( NPDR ) , and proliferative diabetic retinopathy ( PDR ) . The correlation of serum IL-6 and tear fluid IL-6,blood HbA1c and tear fluid IL-6 were assessed by SPSS 19.0 statistical software. Results Concentrations of tear fluid IL-6 were (3.10 ± 1.25)pg/mL in the NGT group, (10.25 ± 3.22)pg/mL in the NDR group,(16.80 ± 5.76)pg/mL in the NPDR group,(25.11 ± 5.20)pg/mL in the PDR group(P < 0.01). SNK-q test revealed significant differences between every two groups (P < 0.01,P <0.05,P < 0.05) Concentrations of serum IL-6 were (88.04 ± 17.06)pg/mL in the NGT group,(126.38 ± 20.73) pg/mL in the NDR group, (239.83 ± 40.33)pg/mL in the NPDR group, (268.36 ± 27.72)pg/mL in the PDR group(P < 0.01). SNK-q test revealed significant differences between every two groups (P < 0.01). Tear fluid IL-6 level was positively correlated with serum IL-6 level(R = 0.756,P < 0.01). Tear fluid IL-6 level was positively correlated with blood IL-6 level (R = 0.338, P < 0.01). Conclusion The tear fluid IL-6 levels of the elderly patients with DM in Shijiazhuang urban communities , increased; with the increased severity of DR , the levels of tear fluid IL-6 gradually increase. The level of tear fluid IL-6, serum IL-6, HbA1c closely correlates with the severity of DR.