2型糖尿病增殖期视网膜病变患者血清胆红素、镁离子水平变化及意义

Changes in levels of serum bilirubin and magnesium in patients with proliferative diabetic retinopathy of type 2 diabetes

目的：探讨血清胆红素和镁（Mg）离子水平变化在2型糖尿病增殖期视网膜病变（PDR）发病中的意义。方法选择2型糖尿病患者340例，按照是否存在糖尿病性视网膜病变（DR）分为糖尿病无视网膜病变（NDR）组130例、糖尿病非增殖期视网膜病变（NPDR）组115例、PDR组95例。收集各组患者的一般资料，包括姓名、性别、年龄、病程、身高、体质量、BMI、收缩压（SBP）。采集清晨空腹肘静脉血，测定各组糖化血红蛋白（HbA1c ）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBIL）、直接胆红素（DBIL）、间接胆红素（IBIL）、血清Mg离子水平。采用 Logistic回归分析法分析导致PDR的危险因素。结果 NPDR组及PDR组血清TBIL、IBIL及Mg离子水平均低于NDR组，PDR组血清TBIL及Mg离子水平均低于NPDR组（P均＜0．05）。TBIL（OR＝0．641，95％CI为0．576～0．714）、Mg（OR＝0．251，95％CI为0．066～0．960）是PDR的保护性因素。结论 PDR患者血清TBIL及Mg离子水平均低于NPDR患者，TBIL、Mg离子是PDR的保护性因素。

Objective To investigate the significance of changes in levels of serum bilirubin and magnesium （Mg）in the pathogenesis of proliferative diabetic retinopathy （PDR）of type 2 diabetes.Methods Totally 340 patients with type 2 diabetes mellitus （T2DM）were recruited.According to whether having diabetic retinopathy （DR）or not,all patients were divided into non-diabetic retinopathy （NDR）group （n=130）,non-proliferative diabetic retinopathy （NPDR）group （n=115）and PDR group （n=95）.General data including name,sex,age,course,height,body mass,BMI,and systolic blood pressure （SBP）were collected.The morning fasting elbow vein blood was collected.Glycosylated hemoglobin A1c （HbA1c ）,total cholesterol （TC）,triglyceride （TG）,low-density lipoprotein cholesterol （LDL-C）,high-density lipopro-tein cholesterol （HDL-C）,alanine aminotransferase （ALT）,aspartate aminotransferase （AST）,total bilirubin （TBIL）, direct bilirubin （DBIL）,indirect bilirubin （IBIL）and serum Mg levels were detected.Logistic regression analysis was used to analyze the risk factors of PDR.Results TBIL,DBIL,IBIL and Mg levels were significant lower in the NPDR and PDR groups than those in the NDR group.TBIL and Mg levels were significant lower in the PDR group than those in the NPDR group （all P〈0.05）.Logistic regression analysis showed TBIL （OR=0.641,95%CI：0.576-0.714）,Mg （OR=0.251,95%CI：0.066-0.960）were protective factors for PDR.Conclusions TBIL and Mg levels in PDR patients were significant lower than those in NPDR patients,and TBIL,Mg were protective factors for PDR.