2型糖尿病视网膜病变血清C肽测定及临床意义  

The measurement of serum C-peptide levels in Type 2 diabetic retinopathy and its clinical significance

作　　者：常家巍[1] 高永峰[2] 

机构地区：[1]郑州大学第一附属医院眼科,郑州450052 [2]河南省眼科研究所,郑州450003

出　　处：《中国实用眼科杂志》2011年第4期337-340,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨血清C肽与2型糖尿病视网膜病变（DR）之间的关系及其临床意义.方法 将2型糖尿病住院病人167例分为3组,其中无糖尿病视网膜病变组（NDR组）60例,非增殖性糖尿病视网膜病变组（NPDR组）76例,增殖性糖尿病视网膜病变组（PDR组）31例.采用化学发光免疫分析法分别测定其空腹血清C肽含量并记录其他可能影响糖尿病视网膜病变发生、发展的因素.根据所测血清C肽值重新将病人分为C肽低值组（LCP组）37例,C肽正常值组（NCP组）78例,C肽高值组（HCP组）52例.结果 NDR组、NPDR组、PDR组空腹血清C肽平均水平呈降低趋势,三组之间空腹血清C肽平均水平比较差异有统计学意义（P＜0.01）.LCP组、NCP组、HCP组之间DR发生率比较差异有统计学意义（x2=46.702,P＜0.01）.Logistic回归分析显示空腹血清C肽水平与DR有明显相关性（B=-1.415,P=0.000）,病程与DR有明显相关性（B=0.404,P=0.000）.C肽水平和糖尿病病程呈负相关（r=-0.479,P=0.000）,C肽水平与DR的程度呈负相关（r=-0.654,P=0.000）.结论 血清C肽在2型DR的发生、发展过程中可能有重要的病理意义,其水平降低可能是2型糖尿病患者DR进展的临床标志.Objective To explore the relationship of serum C-peptide with diabetic retinopathy （DR）and its clinical significance. Methods A total of 167 inpatients with type 2 diabetes were separated into three groups, NDR group （n=60 examination of ocular fundus showed normal）, NPDR group （n=76 examination of ocular fundus showed nonproliferative diabetic retinopathy）, PDR group （n=31 examination of ocular fundus showed proliferative diabetic retinopathy）. Their fasting serum C-peptide （FCP） was tested with chemiluminescent immunoassay. At the same time, other factors that might affect the onset and progression of DR were recorded. Then all the patients were divided according to their C-peptide fasting levels in quartiles again, low C-peptide group （LCP） [n=37], normal C-peptide group （NCP） [n=78], high C-peptide group （HCP） [n=52].Results In three groups, the mean value of FCP in PDR group was the lowest, the NPDR group had the lower concentration than NDR group, [（0.61±0.33） ng/ml vs （1.34± 0.68） ng/ml vs （2.11 ± 0.80） ng/ml, P 〈0.01]. The incidence of DR among LCP group, NCP group and HCP group showed a significant difference （x2=46.702, P 〈0.01）. Logistic regression analysis showed that only C-peptide （B=-1.415, P=0.000）, duration of diabetes （B=0.404, P =0.000） were independently associated with DR. A negative correlation was evident between C-peptide levels and duration of diabetes （r=-0.479, P =0.000）, a negative correlation was also found between C-peptide levels and DR （r=-0.654, P =0.000）. Conclusions Serum C-peptide may have important significance in pathological form of Type 2 DR. The decrease of C-peptide levels may be a maker of the development of DR in type 2 diabetes.

关 键 词：2型糖尿病 糖尿病视网膜病变 血清C肽 

分 类 号：R587.2[医药卫生—内分泌]