2型糖尿病合并视网膜病变患者血浆MDA、SOD和HbA1c水平及意义

Levels and Significances of Serum MDA,SOD and HbA 1c in Patients with Type 2 Diabetic Combined Retinopathy

目的探究2型糖尿病合并视网膜病变患者血浆丙二醛、超氧化物歧化酶和糖化血红蛋白水平变化及其临床意义.方法选取2016年1月~ 2018年2月于笔者医院诊治的168例2型糖尿病患者,根据是否合并视网膜病变分为病变组(n=81)与无病变组(n=87).另选取同期于笔者医院体检的85例健康人员作为正常组.采用硫代巴比妥酸法测定血浆MDA含量,采用邻苯三酚自氧化法测定血浆SOD含量,采用高压液相法测定血浆HbA1c水平,Pearson法对其进行相关性分析,受试者工作特征曲线(ROC)分析血浆MDA、SOD、HbA1c对病变的预测价值,对2型糖尿病合并视网膜病变的影响因素进行Logistics多因素分析.结果病变组与无病变组患者血浆MDA与HbA1c水平均显著高于正常组且病变组显著高于无病变组(P<0.05);病变组与无病变组患者血浆SOD水平显著低于正常组且病变组显著低于无病变组(P<0.05).Pearson相关性分析显示2型糖尿病合并视网膜病变患者血浆MDA水平与HbA1c呈显著正相关(P<0.05),而与SOD水平呈显著负相关(P<0.05);ROC曲线分析显示血浆MDA、SOD、HbA1c的AUC值分别为0.811、0.886、0.778,敏感度与特异性分别为81.25%、62.07%;Logistics多因素分析结果显示患者血浆MDA、SOD、HbA1c均为2型糖尿病合并视网膜病变的危险因素.结论 2型糖尿病合并视网膜病变患者血浆MDA与HbA1c水平升高而血浆SOD水平降低,三者均可作为临床诊断的辅助检查指标.

Objective To explore the changes of plasma malondialdehyde and superoxide dismutase and glycosylated hemoglobin levels in patients with type 2 diabetes mellitus complicated with retinopathy and their clinical significances. Methods Totally 168 patients with type 2 diabetes diagnosed and treated in our hospital from January 2016 to February 2018 were divided into pathological group (81 cases ) and non pathological group( 87 cases) according to whether retinopathy or not. Another 85 healthy persons in our hospital during the same period were selected as normal group. The content of serum MDA was determined by thiobarbituric acid method. The content of plasma SOD was determined by pyrogallic acid autoxidation. The level of plasma HbAlc was measured by high pressure liquid chromatography. The Pearson method was used to take the correlation analysis. Receiver operating characteristic curve( ROC) was used to analyze the predictive value of plasma MDA, SOD and HbAlc. Logistics multivariate analysis was used to analyze the influencing factors of type 2 diabetes mellitus complicated with retinopathy. Results The serum MDA and HbAlc levels in the lesion group and the non lesion group were significantly higher than those in the normal group, and the lesion group was significantly higher than the non lesion group (P < 0. 05 ). The plasma SOD level in the lesion group and the non lesion group was lower than that in the normal group, and the lesion group was significantly lower than the non lesion group( P <0. 05 ). The Pearson correlation analysis showed that the level of plasma MDA in patients with type 2 diabetes mellitus complicated with retinopathy was significantly correlated with HbAl c( P < 0. 05 ), but significantly negatively correlated with the level of SOD ( P < 0. 05 ). ROC curve analysis showed that the AUC values of plasma MDA, SOD and HbAlc were 0.811, 0. 886 and 0. 778 respectively, and the sensitivity and specificity were 81.25% and 62. 07% respectively. Logistics multivariate analysis showed that plasma MDA , SOD and HbAlc were all risk factors for type 2 diabetic retinopathy. Conclusion The level of plasma MDA and HbAl c in patients with type 2 diabetes mellitus complicated with retinopathy is increased, and plasma SOD level is decreased, all of these three can be used the clinical diagnostic plasma indicators.