2型糖尿病伴视网膜病变患者的尿微量白蛋白和超氧化物歧化酶的变化特征

The Analysis of Microalbuminuria and Superoxide Dismutase in Type 2 Diabetic Patients with Different Extent Retinopathy

目的分析超氧化物歧化酶(SOD)和尿微量白蛋白与2型糖尿病视网膜病变的关系。方法收集2型糖尿病152例,行眼底镜检查、OCT+眼底照相检查或者眼底血管荧光造影检查,记录患者的一般临床资料,检测空腹血糖(FPG)、糖化血红蛋白(HbA1c%)、总胆固醇(CHOL)、甘油三酯(TRIG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿素氮(BUN)、血肌酐(CRE)、超氧化物歧化酶(SOD)以及8h尿液中的微量白蛋白。根据眼底检查结果对这些糖尿病患者进行分组,分析不同指标之间的变化;按照尿液微量白蛋白进行分组,分析DR发生率和SOD在不同组之间的差异。统计分析时,对于定量资料:两组间比较采用成组t检验,三组间比较采用单因素方差分析;对于计数资料:两组间比较采用卡方检验,三组间比较采用k样本的非参数统计。结果根据眼底结果分组,血SOD、血CRE、血BUN以及8h尿微量白蛋白在不同的组之间有统计学差异(P<0.05);按照8h尿微量白蛋白的不同程度分组,DR的发病率随着尿微量白蛋白的排出增加而升高(P<0.05),SOD是随着尿微量白蛋白排出的增加而降低。结论血SOD和尿微量白蛋白在糖尿病视网膜病变的过程中发挥一定的作用。

Objective To explore the variation feature of microalbuminuria and superoxide dismutase in different ex-tent diabetic retinopathy patients.Methods One hundred and fifty-two type 2 diabetic patients were chosen in the de-partment of ophthalmology of Beijing Shijitan Hospital.According to the results checked by ophthalmologist,optical co-herence tomography （OCT）,fundus photography or angiography,these type 2 diabetic patients were divided into diabe-tes without retinopathy （NDR）,non-proliferative diabetic retinopathy （NPDR）and proliferative diabetic retinopathy （PDR）.Clinical data was recorded and each patient was detected fasting blood glucose （FBG）,glycated haemoglobin A1c% （HbA1c%）,serum lipid-related metabolic parameters,serum creatinine and superoxide dismutase.Based on mi-croalbuminuria excluded from urine,these type 2 diabetic patients were divided in three groups.For quantitative data, two groups were assessed by independent-samples T test and three groups by One-way ANOVA and LSD.For enumer-ation data,two groups were analyzed by chi-square test and three groups by k-samples non-parametric test.Results According to fundus lesions,the level of microalbuminuria has significant difference in different DR groups（P〈0.05） and the level of superoxide dismutase was decreased in DR groups（P〈0.05）.Based on different level of microalbumin-uria,DR incidence in patients with 30-300 mg/l or beyond 300 mg/l was higher than in less than 30 mg/l patients and the level of superoxide dismutase was reduced with the increase of microalbuminuria.Conclusion Serum superoxide dismutase and microalbuminuria may be involved in the development of DR or diabetic complications.