2型糖尿病视网膜病变患者血清血管内皮生长因子、血管生成素及其受体Tie-2水平及临床意义  

Serum levels and clinical significance of vascular endothelial growth factor,angiopoietin and its receptor Tie-2 in patients with type 2 diabetic retinopathy

作　　者：卢富琨 马丁[1] 马昌军[1] LU Fu-kun;MA Ding;MA Chang-jun(Department of Endocrinology,Bazhong Central Hospital,Bazhong 636600,China)

机构地区：[1]四川省巴中市中心医院内分泌科,巴中市636600

出　　处：《广西医学》2021年第1期35-39,共5页Guangxi Medical Journal

摘　　要：目的探讨2型糖尿病视网膜病(DR)患者血清血管内皮生长因子(VEGF)、血管生成素(Ang)及其受体(酪氨酸蛋白激酶受体Tie-2)的水平及临床意义。方法将169例2型糖尿病(T2DM)患者分为单纯T2DM组(84例)、非增生性DR(NPDR)组(50例)和增生性DR(PDR)组(35例),另选25例健康者作为对照组。比较4组的一般资料、常规血生化指标以及血清Ang-1、Ang-2、Tie-2、VEGF水平。分析DR患者血清Ang-1、Ang-2、VEGF水平和糖化血红蛋白(HbA1c)水平的相关性,采用Logistic回归模型分析T2DM患者发生DR的危险因素。结果(1)单纯T2DM组、NPDR组、PDR组糖尿病病程依次延长,空腹血糖、同型半胱氨酸水平依次升高,PDR组空腹胰岛素水平高于单纯T2DM组,HbA1c水平高于单纯T2DM组及NPDR组(均P<0.05)。(2)单纯T2DM组、NPDR组和PDR组血清Ang-1、Ang-2、VEGF水平高于对照组;单纯T2DM组、NPDR组、PDR组Ang-2和VEGF水平依次升高;PDR组和单纯T2DM组Ang-1水平均低于NPDR组,且PDR组Ang-1/Ang-2值低于NPDR组(均P<0.05);4组Tie-2表达水平差异无统计学意义(P>0.05)。(3)DR患者血清Ang-1、Ang-2和VEGF水平与HbA1c水平呈正相关(均P<0.05)。(4)Logistic回归分析结果显示,糖尿病病程以及HbA1c、Ang-1、Ang-2、VEGF水平是T2DM患者发生DR的影响因素(均P<0.05)。结论与单纯T2DM患者相比,DR患者血清Ang-1、Ang-2、VEGF和HbA1c水平升高,其中Ang-2、VEGF和HbA1c水平升高是T2DM患者发生DR的危险因素,而Ang-1水平升高是保护因素。Objective To investigate the levels and clinical significance of serum vascular endothelial growth factor(VEGF),angiopoietin(Ang)and it receptor(tyrosine protein kinase receptor Tie-2)in patients with type 2 diabetic retinopathy(DR).Methods A total of 169 patients with type 2 diabetes mellitus(T2DM)were divided into simple T2DM group(84 cases),non-proliferative DR(NPDR)group(50 cases)and proliferative DR(PDR)group(35 cases),another 25 healthy individuals were selected as control group.General data,routine blood biochemical indices levels,as well as serum Ang-1,Ang-2,Tie-2 and VEGF levels were compared among the four groups.The correlation of serum Ang-1,Ang-2,VEGF levels with hemoglobin A1c(HbA1c)level was analyzed in DR patients,and the Logistic regression model was used to analyze the risk factors for developing DR in T2DM patients.Results(1)The course of diabetes mellitus increased and the levels of FBG and homocysteine elevated in the order of the simple T2DM group,the NPDR group and the PDR group,the PDR group had a higher fasting insulin level than the simple T2DM group,and exhibited a higher HbA1c level than the simple T2DM group or NPDR group(all P<0.05).(2)Serum Ang-1,Ang-2 and VEGF levels in the simple T2DM group,the NPDR group and the PDR group were higher than those in the control group;the levels of Ang-2 and VEGF increased in turn in the simple T2DM group,the NPDR group and the PDR group;the PDR group and the simple T2DM group had a lower Ang-1 level than the NPDR group,and the PDR group had lower Ang-1/Ang-2 ratio than the NPDR group(all P<0.05);no statistically significant difference in Tie-2 expression level among the four groups(P>0.05).(3)Serum Ang-1,Ang-2 and VEGF levels positively correlated with HbA1c level in DR patients(all P<0.05).(4)Logistic regression analysis results showed that the course of diabetes mellitus as well as the levels of HbA1c,Ang-1,Ang-2 and VEGF was the influencing factors of developing DR in T2DM patients(all P<0.05).Conclusion Compared with patients with simple T2DM,p

关 键 词：2型糖尿病 糖尿病视网膜病变 血管生成素 血管内皮生长因子 酪氨酸蛋白激酶受体Tie-2 

分 类 号：R587.26[医药卫生—内分泌] R[医药卫生—内科学]