不同分期糖尿病视网膜病变患者血清转甲状腺素蛋白浓度检测

Serum transthyretin in patients with different stages of diabetic retinopathy

目的 观察不同分期糖尿病（DM）视网膜病变（DR）患者血清转甲状腺素蛋白（TTR）的浓度。 方法 2型DM患者176例纳入研究。其中，男性104例，女性72例。年龄21～74岁，平均年龄（56±11）岁。DM病程1～30年，平均DM病程（10±7）年。糖化血红蛋白（HbA1C）5.2%～14.1%，平均HbA1C（8.6±2.0）%。确诊为高血压病76例，高脂血症72例。应用胰岛素114例。无DR 118例，占67.0%；DR 58例，占33.0%。DR患者中，Ⅰ期10例，占5.7%；Ⅱ期26例，占14.8%；Ⅲ期8例，占4.5%；Ⅳ期14例，占8.0%。采集患者肘静脉血3 ml，人TTR酶联免疫吸附测定试剂盒检测患者血清TTR浓度。对比分析不同分期DR患者血清TTR浓度差异。采用Bivariate法分析TTR浓度与DR、DM病程、高血压病、高脂血症、胰岛素应用的相关性。 结果 无DR及Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者血清TTR浓度分别为（224.96±65.47）、（383.68±102.99）、（247.44±63.21）、（228.20±45.89）、（189.34±70.12）mg/L。不同分期DR患者血清TTR浓度比较，差异有统计学意义（F=14.690，P＜0.001）。相关性分析结果显示，血清TTR浓度与DR有相关性（r=0.179，P=0.017）；与DM病程（r=–0.027，P=0.727）、高血压病（r=0.018，P=0.810）、高脂血症（r=0.101，P=0.182）、胰岛素应用（r=？0.032，P=0.675）均无相关性。 结论 DRⅠ期患者血清TTR浓度明显升高；随DR进展，血清TTR浓度逐渐降低。TTR浓度与DR有相关性。

Objective To measure the concentration of serum transthyretin （TTR） of patients with different stages of diabetic retinopathy （DR）. Methods A total of 176 patients with diabetes mellitus were included in this study. There were 104 males and 72 females. The patients aged from 21 to 74 years, with the mean age of （56±11） years. The diabetes duration raged from 1 to 30 years, with the mean diabetes duration of （10±7） years. The HbA1C was 5.2%？14.1%, with the mean HbA1C of （8.6±2.0）%. According to the fundus examination, 58 patients had DR （33.0%）, but the other 118 patients not （67.0%）. For these DR patients, 10 patients were in stage Ⅰ （5.7%）, 26 patients in stage Ⅱ （14.8%）, 8 patients in stage Ⅲ （4.5%）, and 14 patients in stage Ⅳ （8.0%）. The concentration of serum TTR was measured by enzyme-linked immunosorbentassay kit. The differences in the concentration of serum TTR between different DR stages were compared.Bivariate analysis was used to analyze the influencing factors of TTR. Results The concentrations of serum TTR of the patients without DR or with DR of stage Ⅰ to Ⅳ were （224.96±65.47）, （383.68±102.99）, （247.44±63.21）, （228.2±45.89）, （189.34±70.12） mg/L, respectively. The difference between different DR stages was statistically significant （F=14.690,P〈0.001）.Bivariate analysis showed that the concentration of TTR was correlation to DR （r=0.179,P=0.017）. There was no correlation between the concentration of TTR and diabetes duration （r=？0.027,P=0.727）, hypertension （r=0.018,P=0.810）, hyperlipoidemia （r=0.101,P=0.182）, and the use of insulin （r=？0.032,P=0.675）. Conclusion The concentration of serum TTR was increased in early DR patients, and gradually decreased with the progression of DR. The concentration of TTR is correlated to DR.