2型糖尿病视网膜病变患者血清sVCAM-1水平的变化和意义

Study of Serum Soluble Vascular Cell Adhesion Molecule-1 Levels in Type 2 Diabetic Patients with Diabetic Retinopathy

研究糖尿病视网膜病变不同时期血清可溶性血管内皮细胞粘附分子 - 1(sVCAM - 1)与视网膜病变严重程度、诊断病程、血清胰岛素和血糖的相关性。采用ELISA法检测 85例 2型糖尿病视网膜病变患者血清sVCAM - 1含量 ,由同一眼科医师通过眼底镜或荧光造影检查 ,将患者分为无视网膜病变组 (NDR)、背景期视网膜病变组(BDR)和增殖期视网膜病变组 (PDR)。结果显示 ,三组糖尿病患者血清sVCAM - 1水平均高于对照组 ,其中PDR组、BDR组血清sVCAM - 1水平与对照组和NDR组比较 ,均有显著性差异 (P <0 .0 1) ,NDR组与对照组比较也存在显著性差异 (P <0 .0 1)。糖尿病患者血清sVCAM - 1水平与血糖、血清胰岛素、诊断病程均无相关性 (P>0 .0 5 )。研究表明 ,糖尿病视网膜病变不同时期血清sVCAM - 1水平的变化可作为判断视网膜病变发展和严重程度的指标 ,为临床早期发现和治疗糖尿病视网膜病变提供较好的依据。

To study the change and the correlation of serum soluble vascular cell adhesion molecule-1(sVCAM-1)levels with diabetic retinopathy in type 2 diabetic patients, serum sVCAM-1 levels were measured in duplicate by ELISA in 85 type 2 diabetic patients; fundus examination was performed by an ophthalmologist using ophthalmoscope or fundus fluorescein angiography, and the findings were graded as: no signs of diabetic retinopathy (NDR), background diabetic retinopathy (BDR) and proliferative diabetic retinopathy (PDR).Serum sVCAM-1 levels were significantly higher in the PDR and BDR groups than those in the control and NDR groups respectively ( P <0.01,). NDR group showed significantly increased serum sVCAM-levels compared with control group( P <0.01;). In contrast, serum sVCAM-1 levles were not related to the presence of blood glucose , serum insulin levels or known diabetic duration. Our results suggest that serum sVCAM-1 might be implicated in the development of the diabetic retinopathy, and could assess the severity of diabetic retinopathy. The measurement of serum sVCAM-1 levels in 2 type diabetic patients may be clinically useful for early diagnosis or treatment of diabetic retinopathy.