2型糖尿病视网膜病变患者糖化血红蛋白测定的临床意义

Clinical significance of glycated hemoglobin exanfining in patients with type 2 diabetic retinopathy

目的 探讨糖化血红蛋白对糖尿病视网膜病变的临床意义.方法 对307例2型糖尿病患者做眼底检查和荧光眼底血管造影检查,分为糖尿病正常眼底（NDR）98例,糖尿病视网膜病变（DR）组209例,其中单纯型视网膜病变（SDR）157例,增殖型视网膜病变（PDR）52例,进行糖化血红蛋白（HbAlc）、空腹血浆葡萄糖（FPG）检测.结果 HbAlc水平越高,视网膜病变发生率越高（P〈0.01）.SDR组HbA1c明显高于NDR组（P〈0.05）,PDR组高于SDR组,差异有统计学意义（P〈0.05）;而FPG水平在SDR组与NDR组无统计学意义（P〉0.05）.结论 控制血浆葡萄糖,降低糖化血红蛋白水平,有助于降低糖尿病视网膜病变发生的危险.

Objective To explore the ellnieal significance of glyeated hemoglobin examining in patients with diabetic retinopathy （DR） . Methods Three hundred and seven eases of type 2 diabetics were ertrolled in this study. The concentrations of glyeated hemoglobin（ HbAle and fasting plasma glueose（ FPG）were measured. And the examination of fundus and fundus fluorescence angiography were performed. Patients were divided into groups： sample diabetic retinopathy group （157 eases）, proliferative diabetic retinopathy group （52 cases） and non diabetic retinopathy group（98 cases）. Results With the concentration of HbAle rising, the incidence and severity of diabetic retinopathy was enhanced（ P 〈 0.01 ）. The concentration of HbAle in sample diabetic retinopathy group was higher than that of proliferative diabetic, retinopathy group, and It Was higher in patients with preliierative diabetic retinopathy than those with sample diabetic retinopathy, There were signifieam sususe diferenees （P 〈 0.05）. But the concentrations of fasting plasma gIueose between sample diabetic retinopathy group and non diabetic retinopath） group had no statistical relation （P 〉 0.05）. Conclusion Controhng the blood sugar, decreasing the glyeated hemodobin level could help to cut risk of diabetic retinopathy.