检测氧化应激指标及血清炎症因子指标对糖尿病视网膜病变患者的临床意义

The Clinical Significance of Detecting Oxidative Stress and Serum Inflammatory Factors in Patients with Diabetic Retinopathy

目的:探讨检测氧化应激指标及血清炎症因子指标对糖尿病视网膜病变(DR)患者的临床意义。方法:选取2019年1月-2020年5月于本院确诊并收治的232例2型糖尿病患者,依据患者是否发生DR分为DR组与NDR组。DR组为合并DR的2型糖尿病患者,共106例,NDR组为未合并出现DR的2型糖尿病患者,共126例。选取同期50例来本院行健康体检的人群,作为对照组。比较三组相关生化指标(空腹血糖、高密度脂蛋白、低密度脂蛋白、总胆固醇及甘油三酯)、血清炎症因子指标(白介素-6、肿瘤坏死因子-α、血管内皮生长因子)、相关氧化应激指标(丙二醛、超氧化物歧化酶)水平。结果:三组FPG、HDL-C、TG水平比较,差异均有统计学意义(P<0.05)。三组LDL-C、TC水平比较,差异无统计学意义(P>0.05)。DR组及NDR组的FPG水平及TG水平均高于对照组,HDL-C水平低于对照组,差异均有统计学意义(P<0.05),DR组与NDR组FPG、HDL-C、LDL-C、TC及TG水平比较,差异均无统计学意义(P>0.05)。三组IL-6、TNF-α、VEGF水平比较,差异均有统计学意义(P<0.05)。DR组及NDR组的IL-6、TNF-α、VEGF水平均高于对照组;且DR组高于NDR组,差异均有统计学意义(P<0.05)。三组MDA、SOD水平比较,差异均有统计学意义(P<0.05)。DR组及NDR组的MDA水平均高于对照组,且DR组高于NDR组,差异均有统计学意义(P<0.05);DR组及NDR组的SOD水平均低于对照组,且DR组低于NDR组,差异均有统计学意义(P<0.05)。结论:DR患者体内的相关炎症因子(IL-6、TNF-α及VEGF)均表现出高水平表达;与此同时,DR患者体内还存在显著的氧化应激表现,在DR的发生及发展过程当中,炎症反应及氧化应激状态参与其中并具有十分重要的作用。对患者的炎症因子IL-6、TNF-α及VEGF,氧化应激指标(MDA及SOD)进行联合检测,可以为临床中对DR患者进行诊断及治疗的过程当中提供参考依据。

Objective:To explore the clinical significance of detecting oxidative stress and serum inflammatory factors in patients with diabetic retinopathy(DR).Method:A total of 232 patients with type 2 diabetes who were diagnosed and treated in our hospital from January 2019 to May 2020 were selected,and they were divided into DR group and NDR group according to whether the patients had DR.The DR group included 106 patients with type 2 diabetes combined with DR,while the NDR group included 126 patients with type 2 diabetes without DR,50 patients who came to our hospital for physical examination during the same period were selected as control group.The levels of related biochemical indexes(fasting plasma glucose,high density lipoprotein,low density lipoprotein,total cholesterol and triglyceride),serum inflammatory factors(interleukin-6,tumor necrosis factor-α,vascular endothelial growth factor),and related oxidative stress indexes(malondialdehyde,superoxide dismutase)were compared among three groups.Result:There were statistically significant differences in the levels of FPG,HDL-C and TG of the three groups(P<0.05).There was no significant difference in LDL-C and TC levels among the three groups(P>0.05).The levels of FPG and TG in DR group and NDR group were higher than those of control group,while the level of HDL-C was lower than that of control group,with statistical significance(P<0.05).There were no significant differences in the levels of FPG,HDL-C,LDL-C,TC and TG between DR group and NDR group(P>0.05).The levels of IL-6,TNF-αand VEGF were significantly differences among three groups(P<0.05).The levels of IL-6,TNF-αand VEGF of DR group and NDR group were higher than those of control group,and those of DR group were higher than those of NDR group,and the differences were statistically significant(P<0.05).There were statistically significant differences in MDA and SOD levels of three groups(P<0.05).MDA levels of DR group and NDR group were higher than those of control group,and that of DR group was higher than those of NDR group,with statistical significance(P<0.05).SOD level of DR group and NDR group were lower than those of control group,and that of DR group was lower than that of NDR group,with statistical significance(P<0.05).Conclusion:Related inflammatory factors in DR patients(IL-6,TNF-αand VEGF)all show high levels of expression;at the same time,DR patients also have significant oxidative stress manifestations.During the occurrence and development of DR,Inflammation and oxidative stress are involved and play a very important role.The combined detection of inflammatory factors IL-6,TNF-αand VEGF,and oxidative stress indicators(MDA and SOD)can provide references for the diagnosis and treatment of DR patients in the clinic.