血浆ET-1、NO和vWF与2型糖尿病视网膜病变相关关系  

Relationship between plasma endothelin 1,nitric oxide and von Willebrand factor and type 2 diabetic retinopathy

作　　者：杜红阳[1] 付海燕[1] 刘丹[1] 孙鹏[1] 

机构地区：[1]锦州医学院附属第一医院眼科,辽宁省锦州市121000

出　　处：《眼科新进展》2006年第9期685-687,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨反映血管内皮功能的标志物血浆内皮素1(endothelin1,ET-1)、一氧化氮(nitric oxide,NO)、血管性假血友病因子(von Willebrand factor,vWF)与2型糖尿病视网膜病变(diabetic retinopathy,DR)严重程度的关系。方法依据WHO标准选择2型糖尿病患者(diabetic mellitus,DM)伴有或不伴有DR85例和健康对照组30人,采用酶联免疫吸附双抗体夹心法和硝酸还原法测定血浆ET-1、vWF和NO,离子交换层析分光光度法测定糖化血红蛋白(hemoglobin A1C,HbA1C),记录相关临床和生化指标。结果2型糖尿病并发DR患者血浆ET-1、vWF水平(分别为3·04μg·L-1±1.27μg·L-1、136.18%±33.64%)显著高于无DR患者组(分别为1.48μg·L-1±1.16μg·L-1、66.68%±19.30%,P<0.01),但血浆NO水平(82.34μg·L-1±17·42μmol·L-1)低于无DR患者组(98·12μg·L-1±33.30μmol·L-1,P<0.05);血浆ET-1水平与收缩压,舒张压和病程呈正相关(r=0.431,0.382和0·450,P<0.05),与空腹血糖、HbA1C、vWF水平呈显著正相关(r=0·561,0.478和0.544,P<0.01);血浆NO与病程、vWF呈负相关(r=-0.431和-0.412,P<0.05);血浆vWF与ET-1、病程、FBG、HbA1C呈正相关(r=0.544,0.313,0.425和0·380,P<0.05),与NO水平呈负相关(r=-0.412,P<0·05)。结论血浆ET-1、NO、vWF水平的检测反映血管内皮功能受损程度可能与DR发生、发展有关,对DR的早期诊断和治疗具有一定意义。Objective To discuss the relationship between the endothelial markers of plasma endothelin 1（ET-1 ）, NO and yon Willebrand factor （vWF） and the severity of diabetic retinopathy（DR）. Methods Eighty-five patients diagnosed with type 2 diabetes by the WHO standard with or without DR,and 30 normal controls were selected. Plasma ET-1 and vWF levels were measured by enzyme-linked immunosorbent assay. NO levels were measured by nitrate reductase method, and hemoglobin A1c（ HbA1 c ） was measured by ion exchange chromatospectrophotometry, and the related biochemical and clinical data were recorded. Results Plasma levels of ET-1 and vWF in the type 2 diabetes with DR （3. 04 μg·L^-1 ± 1. 27 μg·L-1, 136.18% ±33.64%, respectively ） were signifieantly higher than those in the type 2 diabetes without DR （1.48 μg·L-1± 1.16 μg·L^-1,66.68% ± 19.30%,respectively and P 〈 0.01 ）, but NO levels （82.34 μmol·L^- 1 ±17.42 μmol· L^-1） were lower than that in group without DR（98.12 μmol·L^-1± 33.30 μmol·L^-1,P〈0.05）; Plasma levels of ET-1 were positively correlated with systolic blood pressure, diastolic blood pressure and course （ r = 0.431,0. 382 and 0.450, P〈 0.05）, while significantly positively with fasting plasma glucose （FPG）, HbAlc, vWF levels（ r = 0. 561,0. 478 and 0. 544, P〈 0.01 ） ; NO levels were negatively correlated with course and vWF（ r = - 0. 431 and - 0. 412, P 〈0.05） ; vWF levels were positively correlated with ET-1, course,FPG and HbAlc （ r = 0. 544, 0. 313, 0. 425 and 0.380,P 〈 0.05 ） and negatively with NO levels （ r = - 0.412,P 〈 0.05）. Conclusion Measurements of plasma ET-1, NO, vWF levels which reflecting the rank of endothelial dysfunction might be related to DR, and play an important role in early diagnosis and treatment of DR.

关 键 词：糖尿病视网膜病变 内皮素1 一氧化氮 血管性 假血友病因子 2型糖尿病 

分 类 号：R771.3[医药卫生—眼科]