摘要
目的探讨血脂组分异常及超敏C反应蛋白(hs-CRP)与糖尿病视网膜病变进展的相关性。方法对2015年7月至2017年7月该院内分泌科糖尿病住院患者进行眼底检查,通过眼底荧光素钠造影根据病变程度分为3组,未发现视网膜病变组(A组),视网膜病变非增殖期组(B组),视网膜病变增殖期组(C组),检测3组的血脂组分及血清hs-CRP水平,并计算总胆固醇(TC)/高密度脂蛋白胆固醇(HDL-C)比值,用SAS9.4统计软件进行统计学处理。结果糖尿病视网膜病变患者TC/HDL-C比值及血清hs-CRP水平明显升高,3组的hs-CRP水平、TC/HDL-C比值分别与健康对照组比较,差异均有统计学意义(P<0.05);其中A组分别与B组、C组的hs-CRP水平,TC/HDL-C比值比较,差异均有统计学意义(P<0.05);B组和C组的hsCRP水平,TC/HDL-C比值比较差异无统计学意义(P>0.05)。采用线性相关性分析血清hs-CRP水平和TC/HDL-C比值,发现两者具有正向相关性,推测有正向协同作用。结论血清hs-CRP的检测对糖尿病视网膜病变的发生、病情评估及预后具有重要的临床应用价值;TC/HDL-C比值所反映的血脂组分异常也是评估糖尿病视网膜病变发生进展的一个重要的因素。
Objective To study the relationship between the abnormal blood fat components and the serum hypersensitivity C reaction protein concentration and the progression of diabetic retinopathy.Methods Fundus examination was carried out to inpatients in the Department of Endocrinology in the hospital from From July 2015 to July 2017.These patients were divided into three groups according to results of fluorescein sodium contrast:The non retinopathy group(group A),the non proliferative retinopathy group(group B),the retinopathy proliferative phase group(group C).The content of blood fat component and serum hypersensitivity C reaction protein in the experimental cases were measured,and the ratio of TC/HDL-C was calculated.The statistic software of SAS9.4 was used for statistical processing.Results The concentration of the serum hypersensitive C reaction protein in patients with diabetic retinopathy was significantly increased and the ratio of TC/HDL-C increased significantly(P<0.05).The hs-CRP concentration and TC/HDL-C ratio of the three study groups were compared with those of the healthy control group:the difference was statistically significant(P<0.05).Among them,the hs-CRP concentration and TC/HDL-C ratio of group A were compared with group B and group C respectively and the difference were statistically significant(P<0.05).There was no significant difference in hs-CRP concentration and TC/HDL-C ratio between group B and group C(P>0.05).Linear correlation analysis was used to analyze the concentration of serum hypersensitive C reaction protein and the ratio of TC/HDL-C.It was found that there was a positive correlation between them,and there was a positive synergistic effect.Conclusion The measurement of serum hypersensitive C reactive protein has important clinical value for the discovery,evaluation and prognosis of diabetic retinopathy.The abnormalities of the blood fat component reflected by the TC/HDL ratio are also an important factor in assessing the progression of diabetic retinopathy.
引文
[1]高珣祎.长春市中日联谊医院体检中心糖尿病视网膜病变流行病学调查[D].长春:吉林大学,2016.
[2]徐云.2型糖尿病患者视网膜病变相关危险因素临床分析[D].大连:大连医科大学,2014.
[3]张瑞,伊芃芃,周彬.阻塞性睡眠呼吸暂停患者血清脂蛋白(a)和心肌肌钙蛋白Ⅰ检测的临床研究[J].中国医学创新,2009,6(36):1-3.
[4]余慧,秦永文.不同脂质比值水平在心血管疾病预测作用中的研究进展[J].中华老年心脑血管病杂志,2012,14(3):331-332.
[5]祁瑞芳.糖化白蛋白、超敏C-反应蛋白在2型糖尿病合并冠心病中的检测意义[J].西部中医药,2015,28(6):154-155.
[6]陈桂媛.2型糖尿病患者血清hs-CRP和TC/HDL-C联合检测的应用研究[J].实用医技杂志,2008,15(3):301-303.
[7]第三届全国眼科学术会议.糖尿病性视网膜病变分期标准[J].中华眼科杂志,1985,21(2):113
[8] SASONGKO M B,WONG T Y,NGUYEN T T,et al.Novel versus traditional risk markers for diabetic retinopathy[J].Diabetologia,2012,55(3):666-670.
[9]吴庆秋,吴娟,王雅蓉.血清胆红素、TC/HDL-C与糖尿病急性冠脉综合征患者的冠脉病变程度的相关因素分析[J].宁夏医学杂志,2017(9):820-822.
[10]ALDEBASI Y H,MOHIELDEIN A H,ALMANSOUR Y S,et al.Dyslipidemia and lipid peroxidation of Saudi type 2diabetics with proliferative retinopathy[J].Saudi Med J,2013,34(6):616-622.
[11]陈国新,赵立忠,冼小珍,等.2型糖尿病视网膜病变检测血清同型半胱氨酸,糖化血红蛋白及超敏C-反应蛋白的临床意义[J].医学检验与临床,2016,27(5):18-20.
[12]管东.糖化血红蛋白和超敏C反应蛋白检测对2型糖尿病并发症的临床分析[J].北方药学,2016,13(3):163-164.
[13]贾扬地,张其根.血清超敏C-反应蛋白水平与心脑血管疾病关系探讨[J].蚌埠医学院学报,2003,28(5):453-454.
[14]胡敏,王继贵,杨波.超敏C反应蛋白与血脂联合分析在心血管疾病中的应用[J].中国现代医学杂志,2003,13(9):95-97.
[15]NAKANISHI N,SHIRAISHI T,WADA M.Association between C-reactive protein and insulin resistance in a Japanese population:the Minoh Study[J].Intern Med,2005,44(6):542-547.
[16]施六霞,金岳龙,王祥雨,等.高血压、2型糖尿病并发牙周炎患者超敏C-反应蛋白及炎性细胞因子表达分析[J].中国临床药理学与治疗学,2015,20(5):541-545.
