摘要
目的探讨血清β_(2)-糖蛋白Ⅰ(β_(2)-GPⅠ)、和肽素(Copeptin)水平与糖尿病视网膜病变(DR)患者视力残疾的关系。方法选择DR患者152例,根据眼底检查结果分为增殖期组54例、非增殖期组98例。同期另选单纯糖尿病患者42例(单纯糖尿病组),眼底检查均未发现视网膜微血管病变。所有患者入院24 h内采集清晨空腹肘静脉血,离心留取血清,采用ELISA法检测血清β_(2)-GPⅠ、Copeptin。DR患者规范治疗后随访1年,评估视力,根据视力将患者分为视力残疾者与非视力残疾者。收集视力残疾者与非视力残疾者基础临床资料(包括性别、年龄、BMI、糖尿病病程)、实验室检查资料[包括血脂(TC、TG、HDL-C、LDL-C)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、HOMA-IR指数以及血清β_(2)-GPⅠ、Copeptin水平],采用多因素Logistic回归模型分析DR患者视力残疾的危险因素。结果单纯糖尿病组、非增殖期组、增殖期组血清β_(2)-GPⅠ和Copeptin水平逐渐升高(P均<0.05)。DR患者治疗后随访1年,出现视力残疾33例、非视力残疾119例。视力残疾者糖尿病病程、FPG、HbA1c、HOMA-IR指数以及血清β_(2)-GPⅠ、Copeptin水平均明显高于非视力残疾者(P均<0.05)。多因素Logistic回归分析显示,糖尿病病程、HbA1c、β_(2)-GPⅠ、Copeptin是DR患者视力残疾的独立危险因素(P均<0.05)。结论 DR患者血清β_(2)-GPⅠ、Copeptin水平明显升高,并且出现视力残疾者血清β_(2)-GPⅠ、Copeptin水平明显高于未出现视力残疾者;血清β_(2)-GPⅠ、Copeptin水平升高是导致DR患者视力残疾的重要原因。
Objective To investigate the relationships between the levels of serumβ_(2)-glycoproteinⅠ(β_(2)-GPⅠ)and Copeptin and visual disability in diabetic retinopathy(DR)patients.Methods Totally 152 patients with DR were selected and were divided into the proliferative group(54 cases)and non-proliferative group(98 cases)according to the re⁃sults of fundus examination.In the same period,42 diabetic patients(simple diabetes group)with no retinal microangiopa⁃thy in fundus examination were selected.Early morning fasting elbow venous blood was collected from all patients within 24 h of admission;serum was extracted by centrifugation,and the serumβ_(2)-GPⅠand copeptin levels were determined by ELISA.DR patients were followed up for 1 year after standard treatment,and the visual acuity of the patients was evaluat⁃ed.According to the vision,the patients were divided into patients with visual disability and patients without visual disabil⁃ity.The basic clinical data(including gender,age,BMI,duration of diabetes)and laboratory examination data[includ⁃ing blood lipids(TC,TG,HDL-C,LDL-C),fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),fasting in⁃sulin(FINS),HOMA-IR index,and serumβ_(2)-GPⅠand copeptin levels]of patients with and without visually disability were collected.Multivariate Logistic regression model was used to analyze the risk factors for visual disability in DR pa⁃tients.Results The levels of serumβ_(2)-GPⅠand Copeptin of the simple diabetes group,non-proliferative group and pro⁃liferative group increased gradually(all P<0.05).DR patients were followed up for 1 year after treatment,and 33 cas⁃es had visual disability and 119 cases did not have visual disability.The duration of diabetes,FPG,HbA1c,HOMA-IRindex and the levels of serumβ_(2)-GPⅠand Copeptin in patients with visual disability were significantly higher than those of patients without visual disability(all P<0.05).Multivariate Logistic regression analysis showed that the duration of di⁃abetes,HbA1c,β_(2)-GPⅠand Copeptin were independent risk factors for visual disability in DR patients(all P<0.05).Conclusion The levels of serumβ_(2)-GPⅠand Copeptin of DR patients increased significantly,and the levels of serumβ_(2)-GPⅠand Copeptin in patients with visual disability were significantly higher than those without visual disability;the increase of serumβ_(2)-GPⅠand Copeptin levels were the main causes of visual disability in DR patients.
作者
向清平
李菲
陈娟
罗静
XIANG Qingping;LI Fei;CHEN Juan;LUO Jing(Department of Ophthalmology,Chengdu Fifth People's Hospital,Chengdu 611130,China)
出处
《山东医药》
CAS
2021年第25期10-13,共4页
Shandong Medical Journal
基金
四川省卫生和计划生育委员会科研课题(17P0178)
成都市医学科研课题(2019098)。
