糖尿病及其视网膜病变患者氧化应激状态的评价  

Study of Oxidative Stress Status in Patients with Diabetes Mellitus and Diabetic Retinopathy

作　　者：陈文华[1] 郭欣[2] 邢燕[2] 郭美宜[3] 许风娟[2] 常东[2] 潘洪志[1] 

机构地区：[1]哈尔滨医科大学公共卫生学院研究生科,黑龙江省哈尔滨市150081 [2]哈尔滨医科大学附属第一医院检验科 [3]哈尔滨医科大学附属第二医院体检中心

出　　处：《中国全科医学》2010年第11期1173-1175,共3页Chinese General Practice

摘　　要：目的观察糖尿病及其视网膜病变患者血清抗氧化酶活性及非酶类抗氧化物、氧化应激代谢产物的水平,探讨氧化应激与糖尿病视网膜病变之间的关系。方法选择51例2型糖尿病患者,其中糖尿病无并发症者24例(DM组),糖尿病合并视网膜病变者27例(DR组),另选择同期行体检的30例健康者为对照组。收集3组受检者的空腹血清,测定血清抗氧化酶〔超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)及过氧化氢酶(CAT)〕活性、非酶类抗氧化物〔维生素C(VC)、维生素E(VE)及还原型谷胱甘肽(GSH)〕水平及氧化应激代谢产物〔丙二醛(MDA)、共轭二烯(CD)及晚期蛋白质氧化产物(AOPP)〕水平。结果(1)DM组患者血清SOD、GSH-Px、CAT活性分别为(108±14)U/ml、(141±30)U/ml和(5.6±1.6)U/ml;DR组患者分别为(96±13)U/ml、(133±25)U/ml和(5.1±1.4)U/ml;对照组分别为(119±28)U/ml、(156±26)U/ml和(6.8±1.6)U/ml;与对照组比较,DM组及DR组患者血清抗氧化酶活性均显著降低(P<0.05),且DR组患者SOD活性又显著低于DM组患者(P<0.05)。(2)对照组VC、VE、GSH水平分别为(86±26)mg/L、(19.0±5.3)mg/L和(22.0±5.9)μmol/L;DM组患者分别为(64±20)mg/L、(16.6±3.7)mg/L和(20.8±8.2)μmol/L;DR组患者分别为(52±10)mg/L、(16.6±3.7)mg/L和(19.7±5.7)μmol/L;与对照组比较,DM组及DR组患者血清VC水平均显著降低(P<0.01),而DR组患者血清VC水平又显著低于DM组(P<0.05)。(3)对照组血清MDA、CD、AOPP水平分别为(3.1±1.3)μmol/L、(0.32±0.06)和(15.8±4.5)μmol/L;DM组患者分别为(5.4±1.8)μmol/L、(0.43±0.23)和(25.6±7.7)μmol/L;DR组患者分别为(7.9±2.6)μmol/L、(0.57±0.27)和(27.8±7.2)μmol/L;与对照组比较,糖尿病患者氧化应激代谢产物水平显著升高(P<0.05),且DR组患者血清MDA、CD水平较DM组患者显著升高(P<0.05)。结论糖尿病及其视网膜病变患者存在着严重的氧化应激,且糖尿病视网膜病变患者氧化应激更严重。Objective To observe antioxidative enzymes, non - enzyme antioxidants and metabolite level of oxidative stress in T2DM patients with or without retinopathy to explore the relationship between oxidative stress and diabetic retinopathy. Methods Fifty - one T2DM patients were divided into groups DM （ without complications, n = 24 ） and DR （ with retinopathy, n = 27 ）, and another 30 healthy subjects were enrolled as control group. Superoxide dismutase （SOD）, glutathione peroxidase （GSH-Px）, catalase （CAT）, vitamin C （Vc）, vitamin E （VE）, glutathione （GSH）, malondialdehyde （MDA）, conjugated diene （CD） and advanced oxidation protein products （AOPP） were detected. Results The levels of SOD, GSH - Px, CAT activity of DM group （ 108 ± 14 U/ml, 141 ± 30 U/ml, 5.6 ± 1.6 U/ml, respectively） and DR group （96 ± 13 U/ml, 133 ±25 U/ml, 5.1 ± 1.4 U/ml, respectively） decreased significantly, as compared with control （119 ±28 U/ml, 156 ±26 U/ml, 6. 8 ± 1.6 U/ml, respectively） （P 〈 0. 05 ）. SOD were significantly lower in DR group than in DM （ P 〈 0. 05 ）. The levels of VC, VE, GSH in serum were 86±26 mg/L, 19. 0±5.3 mg/L, 22.0 ±5.9 μmol/L, respectively, in control group, and64±20 mg/L, 16.6±3.7 mg/L, 20.8 ±8.2 μmoL/L, respectively, in DM patients, and 52 ±10 mg/L, 16.6±.7 mg/L, 19.7 ±5.7 μmol/L, respectively, in DR group. As compared with control, VC decreased in groups DM and DR （P 〈 O. 01 ）. And Vc was lower in DR group than in DM group （P 〈0. 05）. MDA, CD and AOPP of groups DM （5.4 ± 1.8 μmol/ L, 0. 43 ±0. 23, 25.6 ±7. 7 μmol/L, respectively） and DR （7.9 ±2. 6 μmol/L, O. 57 ±0. 27, 27. 8±7.2 μmol/L, respectively） were significantly higher than those of control （3.1 ± 1.3 μmoL/L, 0. 32±0.06, 15.8±4. 5 μmol/L, respectively） （P 〈 0. 05 ）. The levels of MDA and CD in DR group elevated significantly as compared with DM group （ P 〈 0. 05 ）. Conclusion Oxidative stress is severe in diabetic pat

关 键 词：糖尿病 2型 糖尿病视网膜病变 氧化应激 

分 类 号：R587.26[医药卫生—内分泌]