血清血小板内皮细胞黏附分子-1水平变化对糖尿病视网膜病变的影响  

Influence of platelet endothelial cell adhesion molecule-1 on diabetic retinopathy in patients with type 2 diabetes

作　　者：张靖东[1] 蔡成平[1] 魏迎风[2] 胡楠[3] 

机构地区：[1]南通市第三人民医院眼科,226006 [2]南通市第三人民医院内分泌科,226006 [3]南通大学附属医院眼科实验室,226001

出　　处：《中华实验眼科杂志》2012年第12期1127-1130,共4页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景研究糖尿病视网膜病变（DR）发生发展的相关危险因素对DR的预防有重要意义，血小板内皮细胞黏附分子-1（PECAM-1）是介导糖尿病患者血管病变发生的重要介质，但其作用机制仍有待进一步研究。目的探讨2型糖尿病患者血清中PECAM-1水平变化对DR发生及发展的影响。方法收集在南通市第三人民医院内分泌科确诊的2型糖尿病患者共54例，根据检眼镜检查和荧光素眼底血管造影（FFA）结果，依据1987年中华医学会DR分期标准将患者分为无DR（NDR）组18例、非增生型糖尿病视网膜病变（NPDR）组20例和增生型糖尿病视网膜病变（PDR）组16例，并收集年龄和性别与患者相匹配的18名健康体检者作为正常对照组。收集患者外周血，用ELISA法检测患者血清中PECAM一1的质量浓度；用高效液相色谱法检测患者血清中糖化血红蛋白（HbAlC）含量；采用全自动生化分析仪检测患者的血糖水平；探讨DR患者PECAM—l质量浓度与HbAlC含量的关系，并将各组患者的检测结果进行比较。结果PDR组、NPDR组、NDR组和正常对照组患者血清中PECAM-1质量浓度分别为（10．907-4-2．792）、（7．024±2．377）、（5．231±1．816）和（3．817±1．045）μg／L，总体差异有统计学意义（F=12．630，P=0．002），PDR组患者血清PECAM—l质量浓度明显高于NPDR组、NDR组和正常对照组，差异均有统计学意义（P〈0．05）。PDR组、NPDR组、NDR组和正常对照组患者血清HbAlC水平分别为（12．596±3．148）％、（9．118±3．356）％、（5．491±1．017）％和（4．992＋-0．725）％，总体比较差异有统计学意义（F=7．130，P=0．015），PDR组、NPDR组患者血清HbAlc水平显著高于NDR组和正常对照组，PDR组PECAM一1和HbAlc水平明显高于NPDR组和正常对照组，差异均有统计学意义（P〈0．05）。PDR组、NPDR组、NDR组患者血清PECAM-1质量浓度与血清HbAlc�Background To study diabetic retinopathy （DR） related risk factors is very important in the prevention of DR. Platelet endothelial cell adhesion molecule-1 （ PECAM-1 ） is an important mediator that mediates high blood glucose-induced vascular diseases in diabetic patients. However, its mechanism is still below understood. Objective This clinical study was to investigate the effect of serum level changes of PECAM-1 on DR in type 2 diabetic patients. Methods Fifty-four patients with type 2 diabetes were enrolled from the endocrinology department of the Third People＇ s Hospital of Nantong City. Fundus examination was performed using the ophthalmoscope and fundus fluorescence angiography （FFA） on all the patients, and these patients were grouped as the non-DR （NDR） group （ 18 cases） , non-proliferative DR （NPDR） group （20 cases） and proliferative DR group （PDR） （16 cases） based on the DR staging criterion of the Chinese Medical Association （1987 version）. Eighteen age- and gender-matched normal subjects served as the normal control group. Peripheral blood was collected, and serum PECAM-1 levels were assayed using ELISA. Serum HbAlc levels were detected using the high performance liquid colorimetric（HPLC） method. The correlation of serum PECAM-1 level with serum HbAlc level was analyzed. All results were compared among the groups. Results The serum PECAM-1 levels were （ 10. 907 ± 2. 792 ） , （ 7. 024 ＋2. 377 ） , （ 5.231 _＋ 1.816 ） and （ 3.817 ＋- 1. 045 ） Ixg/L, respectively, in the PDR group, NPDR group, NDR group and normal control group, showing a significant difference among the 4 groups （ F = 12. 630, P = 0.02 ）. Serum PECAM-1 content was significantly higher in the PDR group when compared with the NPDR group, NDR group and normal control group （ P〈0. 05 ）. The serum ItbA 1 c levels were （ 12. 596± 3. 148 ） %, （ 9. 118± 3. 356 ） %, （ 5.491 ± 1. 017）% and （4. 992± 0. 725 ）% in the PDR group, NPDR group, NDR group and n

关 键 词：糖尿病 并发症 视网膜病变 血小板内皮细胞黏附分子-1 糖化血红蛋白 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]