2型糖尿病视网膜病变与U-ALB及血Fb、Hb水平的相关性分析

Correlation of diabetic retinopathy with U-ALB and blood Fb,Hb levels in patients with type 2diabetes mellitus

目的探讨2型糖尿病患者尿微量白蛋白(urine microalbuminuria,U-ALB)排出量及血纤维蛋白原(fibrinogen,Fb)、血红蛋白(hemoglobin,Hb)在糖尿病视网膜病变发生中的可能意义。方法 2010年1月至2014年9月我院收治的101例2型糖尿病患者,按照是否伴视网膜病变分为无合并症组(n=49)及合并视网膜病变组(n=52,其中单纯期38例,增殖期14例);健康体检者作为对照(n=50)。151例受试者均接受临床指标[体质指数(BMI)、空腹血糖、收缩压和舒张压等]检查,并检测U-ALB及血Fb、Hb水平。结果 2型糖尿病患者U-ALB高于正常受试者,且合并视网膜病变组高于无合并症组,差异均有统计学意义(P<0.01);2型糖尿病患者血Fb水平高于正常受试者,且合并视网膜病变组高于无合并症组,差异均具有统计学意义(P<0.01);正常受试者Hb水平高于2型糖尿病患者,且合并视网膜病变组低于无合并症组,差异均具有统计学意义(P<0.01)。与单纯期视网膜病变患者相比,增殖期视网膜病变患者U-ALB及血Fb、Hb变化趋势更明显(P<0.01)。结论2型糖尿病患者存在U-ALB及血Fb、Hb水平的改变,且合并视网膜病变患者改变更明显。

Objective To explore the clinical significance of urine microalbuminuria （U-ALB） and blood fibrinogen （Fb） and hemoglobin （Hb） levels in retinopathy of patients with type 2 diabetes mellitus （T2DM）. Methods From Jan. 2010 to Sep. 2014, a total of 101 T2DM patients who were treated in our hospital were enrolled in this study. According to whether combined with retinopathy the patients were divided into 2 groups. non-complication group （49 cases） and diabetic combined with retinopathy group （DR-complication group 52 cases, 38 patients with non-proliferative DR and 12 cases with proliferative DR）. In addition, 50 healthy subjects were enrolled as controls. All the participants were examined for BMI, fasting blood glucose, and blood pressure. The urinary U-ALB level and blood Fb/Hb were also determined. Results The urine U-ALB level of T2DM patients was significantly higher than that in healthy subjects, and that in DR-complication group was significantly higher than that in the non-complication group （all P〈0. 01）. Plasma Fb level in T2DM patients was significantly higher than that in healthy subjects, and that in the DR-complication group was significantly higher than that in the non-complication group （all P〈0. 01）. Hb level in healthy subjects was significantly higher than that in patients with type 2 diabetes, and that in the DR-complication group was significantly lower than that in the non-complication group （all P〈0. 01）. Compared with the nonproliferative DR patients, the changes of urine U-ALB and blood Fb/Hb in the proliferative DR patients were significantly greater（P〈0.01）. Conclusion Urine U-ALB level and blood Fb and Hb levels are changed in patients with type 2 diabetes mellitus, and the changes are even greater in those complicated with diabetic retinopathy.