血小板反应蛋白1在2型糖尿病患者视网膜病变中的临床意义

Clinical value of thrombospondin-1 in patients with type 2 diabetic retinopathy

目的探讨血清血小板反应蛋白1(TSP-1)在DR患者中的水平变化及临床意义。方法选取120例研究对象,分为T2DM组(T2DM,n=31)、T2DM合并背景期视网膜病变组(T2DM+背景期视网膜病变,n=31)、T2DM合并增殖期视网膜病变组(T2DM+增殖期视网膜病变,n=29)及正常对照组(NC,n=29)。检测各组TSP-1、FPG、FIns、HbA1c、血脂、纤维蛋白原(Fib)等指标。结果各组血清TSP-1水平[(261.12±38.11)vs(284.66±38.74)vs(329.26±37.81)vs(121.60±10.78)ng/ml,P<0.01]比较差异有统计学意义。Pearson相关性分析显示,TSP-1与FPG、FIns、HbA1c、TC、LDL-C、Fib呈正相关,与HDL-C呈负相关。Logistic多元逐步回归分析显示,FIns、HbA1c、LDL-C、Fib是TSP-1的独立影响因素(t=4.182、6.054、-2.097、3.943,P<0.05或P<0.01)。血清TSP-1与Fib是DR发生的危险因素(t=-5.484、3.208,P<0.01)。结论 TSP-1与DR的发生发展关系密切,是DR的危险因素。

Objective To investigate the changes and clinical significance of thrombospondin-1 （TSP- 1） in patients with type 2 diabetic retinopathy. Methods A total of 120 patients were enrolled in this study and divided into four groups.. T2DM group（T2DM, n = 31）, T2DM combined with background retinopathy （T2DM±background retinopathy, n = 31）, T2DM group with proliferative retinopathy （T2DM＋ proliferative retinopathy, n=29） and normal controls （NC, n= 29）. TSP-1, FPG, Fins, HbA1 c, blood lipid and fibrinogen （Fib） were detected in each group. Results There was significant difference in serum TSP-1 level in the four groups[（261.12±38.11） vs （284.66±38.74） vs （329.26±37.81） vs （121.60±10.78） ng/ml, P 〈 0. 01]. Pearson correlation analysis showed that TSP-1 was positively correlated with FPG, Fins, HbA1 c, TC, LDL-C and Fib, while negatively correlated with HDL-C. Multiple linear regression analysis showed that Fins, HbA1 c, LDL-C and Fib were independent influencing factors for serum TSP-1 （t =4. 182, 6. 054, - 2. 097, 3. 943）. TSP-1 and Fib were risk factors for diabetic retinopathy （DR）（t=-5. 484,3. 208, P〈0.01]. Conclusion TSP-1 might play a role in the occurrence and progression of DR. It was a risk factor for DR.