红细胞膜磷脂及过氧化脂质变化与糖尿病视网膜病变的关系

Relationship between changes of phospholipid and lipid peroxide of erythrocyte membrane and diabetic retinopathy

目的探讨糖尿病患者红细胞膜磷脂成分和过氧化脂质（ｌｉｐｉｄｐｅｒｏｘｉｄｅ，ＬＰＯ）水平的改变与糖尿病视网膜病变的关系。方法对４４例糖尿病视网膜病变患者、２０例糖尿病无视网膜病变患者及３０例正常人的血脂、糖化血红蛋白（ｇｌｙｃｏｓｙｌａｔｅｄｈｅｍｏｇｌｏｂｉｎ，ＨｂＡ１ｃ）、红细胞膜磷脂成分、ＬＰＯ及红细胞超氧化物歧化酶（ｓｕｐｅｒｏｘｉｄｅｄｉｓｍｕｔａｓｅ，ＳＯＤ）、谷胱甘肽过氧化物酶（ｇｌｕｔａｔｈｉｏｎｅｐｅｒｏｘｉｄａｓｅ，ＧＳＨＰＸ）活性等进行检测及分析。结果糖尿病患者红细胞膜磷脂酰乙醇胺、磷脂酰肌醇、磷脂酰丝氨酸、磷脂酰胆碱、神经鞘磷脂、红细胞ＳＯＤ及ＧＳＨＰＸ活性均显著低于对照组；溶血磷脂酰胆碱、ＬＰＯ、甘油三脂、胆固醇及ＨｂＡ１ｃ则显著高于对照组，这些改变在糖尿病视网膜病变患者更为明显。结论糖尿病患者红细胞膜脂质过氧化。

Objective To study the relation between the changes of phospholipid and lipid peroxide (LPD) in erythrocyte membrane in diabetes mellitus with the occurrence of diabetic retinopathy (DR). Methods The levels of triglyceride (TG), cholesterol (TC), glycosylated hemoglobin (HbA 1c), phosphatidylethanolamine (PE), phosphatidylinostiol (PI), phosphatidylserine (PS), phosphatidylcholine (PC), sphingomyelin (SM), lysophosphatidylcholine (LPC), lipid peroxide (LPO) and the activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH PX) were investigated in 44 diabetic patients with DR, 20 diabetic patients with no DR (NDR) and 30 sex and age matched normal control subjects. Results A significant decrease in PE, PI, PS, PC, SM, SOD and GSH PX and a significant increase in LPC, LPO, TG, TC and HbA lc were detected in DR and NDR group when compared with the normal controls. These changes were more obvious in DR group. Conclusion The lipid peroxidation and the alteration of the erythrocyte membrane phospholipid compositions may contribute to the occurrence and development of DR.