糖尿病视网膜病变患者血浆血栓调节蛋白和D-二聚体水平的研究

The changes of plasma thrombomodulin and D-Dimer(D-D)level in patients with diabetic retinopathy

目的探讨血栓调节蛋白(TM)和D-二聚体(D-D)与DR的关系。方法将60例糖尿病患者按眼底视网膜病变程度分为糖尿病无视网膜病变期(NDR),单纯型糖尿病视网膜病变期(SDR)和增殖型糖尿病视网膜病变期(PDR)。另选健康者30名作为正常对照(NC)组。测定各组血浆TM浓度及D-D浓度,同时研究TM与D-D的相关性。结果 (1)NDR、SDR和PDR组血浆TM水平[(27.17±18.30)、(39.67±18.41)和(61.83±24.31)ng/ml]均高于NC组[(15.63±13.79)ng/ml](P<0.05);(2)NDR组血浆D-D水平[(0.19±0.07)μg/ml]与NC组[(0.17±0.06)μg/ml]比较,差异无统计学意义(P>0.05);SDR、PDR组[(0.24±0.06)、(0.57±0.09)μg/ml]均高于NDR组与NC组(P<0.05);(3)血浆TM与D-D呈正相关(r=0.508,P<0.01)。结论检测血浆TM及D-D水平可帮助评价糖尿病患者血管内皮细胞损伤的情况,以及眼底视网膜病变程度,同时可反映体内是否存在高凝状态。

Objective To study the changes of plasma thrombomodulin and D-Dimer（D-D） level in patients with diabetic retinopathy. Methods 60 diabetic patients were divided into three groups： no diabetic retinopathy （NDR） group, simple diabetic retinopathy （SDR） group, and proliferative diabetic retinopathy（PDR） group. And 30 normal persons were also recruited as the control group. The plasma levels of TM and D-D were examined, and relationship between TM and DD was also investigated. Results （1） The plasma TM levels were higher in NDR group [（27.17 ±18.30）ng/ml＇], SDR group [（39.67±18. 41）ng/ml],PDR group[-（61.8±24. 31）ng/ml] than in control group[（15.63±3. 79） ng/ml ] （P〈0.05） . The plasma TM level was higher in PDR group than in SDR and NDR groups（P〈0.05）. （2） There was no statistical difference in D-D between NDR group[（0.19±0.07） μg/ml ] and control group[（0.17±0.06） μg/ml]. The plasma D-D levels were higher in PDR group[（0.57±0.09）μg/ml ] and SDR group[（0.24±0; 06） 〉g/ml] than in NDR and control groups, and it was also higher in PDR group than in SDR group（P〈0. 05）. （3）TM level was positively correlated with D-D level（r= 0. 508, P〈0.01）. Conclusion Clinical determination of plasma TM and D-Dimer level can help evaluate diabetic vascular endothelial cell injury and degree of fundus retinopathy, and reflect the presence of high coagulation state in the body at the same time.