2型糖尿病并发视网膜病变患者血清缺血修饰白蛋白和超敏C-反应蛋白浓度的变化

Changes of the concentration of serum ischemia modified albumin and high sensitivity C-reactive protein in type 2 diabetic patients with retinopathy

目的探讨2型糖尿病并发视网膜病变（DR）患者血清缺血修饰白蛋白（IMA）和超敏C-反应蛋白（hs-CRP）浓度的变化。方法病例对照研究。采用酶联免疫吸附测定法和速率散射比浊法检测79例DR组患者血清IMA和hs-CRP浓度变化，并与83例非DR（NDR）糖尿病组患者和72例对照组受检者进行比较，同时将40例增殖性DR（PDR）组患者与39例非增殖性DR（NPDR）组患者进行比较。采用PPMS1．5统计学软件进行数据分析。两组均数比较采用t检验；多组均数比较采用单因素三水平设计定量资料方差分析，多个均数之间两两比较采用q检验。结果DR组患者血清IMA浓度（46．51±13．29）μg／L，hs-CRP浓度（4．27±2．24）mg／L；NDR组患者血清IMA浓度（25．47±9．33）μg／L，hs-CRP浓度（2．96±1．84）mg／L；对照组血清IMA浓度（15．36±4．27）μg／L，hs．CRP浓度（1．86±0．97）mg／L；PDR组患者血清IMA浓度（54．72±15．61）μg／L，hs-CRP浓度（6．34±3．53）mg／L；NPDR组患者血清IMA浓度（38．35±11．27）μg／L，hs-CRP浓度（3．28±1．77）mg／L。DR组患者血清IMA和hs-CRP浓度明显高于对照组和NDR组，NDR组患者血清IMA和hs-CRP浓度高于对照组，差异有统计学意义（F=197．124，34．561；q=5．41～27．34；P〈0．01）；PDR组患者血清IMA和hs-CRP浓度明显高于NPDR患者组，差异有统计学意义（t=5．46，4．89；P〈0.01）；DR组患者血清IMA与hs-CRP浓度呈正相关（r=0．617，P〈0．01）。结论DR患者血清IMA和hs-CRP浓度明显升高，且与病情严重程度呈正相关，可能影响DR的发展。

Objective To explore the changes of the concentration of serum ischemia modified albumin（IMA） and high sensitivity C-reactive protein（hs-CRP） in type 2 diabetic patients with retinopathy （DR）. Methods The concentration of serum IMA and hs-CRP in DR patients were determined by ELISA and ratenephelometry and compared with those in 83 no-DR （NDR） patients and 72 controls. The concentration of serum IMA and hs-CRP in 40 proliferative diabetic retinopathy （PDR） patients were compared with those in 39 no-PDR （NPDR） patients. Data was evaluated using analysis of PPMS version 1.5. Results are expressed as means ＋ standard deviation of the mean. Statistical comparisons were performed by student＇s t-test or one-way analysis of varrance followed by Dunnett＇s multiple comparison test and the means compared each other using q test. Results The serum IMA and hs-CRP concentration in DR patients were （46. 51 ± 13.29）μg/L, （4. 27 ±2. 24）mg/L. The serum IMA and hs-CRP concentration in NDR patients were（25.47 ± 9. 33 ） μg/L, （2. 96 ± 1.84 ）mg/L. The serum IMA and hs-CRP concentration in controls were （ 15.36 ± 4. 27 ） μg/L, （ 1.86 ± 0. 97 ） mg/L. The serum IMA and hs-CRP concentration in PDR patients were（54. 72 ±15.61 ） μg/L, （6. 34 ± 3.53 ） mg/L. The serum IMA and hs-CRP concentration in NPDR patients were （38.35 ± 11.27 ） μg/L, （3.28 ± 1.77 ） mg/L. The serum IMA and hs-CRP concentration were significantly higher in DR patients than those in controls and NDR patients, the serum IMA and hs-CRP concentration in NDR patients were significantly higher than those in controls （ F =197. 124,34. 561 ;q =5.41-27. 34;P 〈0.01 ） ; the serum IMA and hs-CRP concentration were significantly higher in PDR patients than those in NPDR patients （ t = 5.46,4. 89 ; P 〈 0. 01 ） ; there was significant positive correlation between serum IMA concentration and hs-CRP concentration in DR patients（ r = 0. 617, P 〈 0. 01 ）. Conclusion The serum IMA and hs-CRP concentration were significantly high in DR patients, and were positively associated with the seriousness of DR, which may contribute to the development of DR.