2型糖尿病视网膜病变与血清脂蛋白（a）的关系

摘要

Objective To investigate the changes of serum Lp(a) levels of patients with type-2 diabetes mellitus complicated by diabetic retinopathy and its clinical significance. Method We tested serum Lp(a) levels of normal control subjects, Type-2 diabetics and those accompanied with diabetic retinopathy complications. Meanwhile, the levels of TG, TC, LDL-C, and HDL-C for the three groups were measured and the relationship of Lp(a) to the disease were analyged. Results It was found that the Lp(a), TC and LDL-C in one group patients (diabetes mellitus complicated by diabetic retinopathy) were significantly higher than that in the other two groups (P<0.05);and there is no similar changes of serum TG (P>0.05). Conclusion The serum Lp(a) levels are increased in Type-2 diabetes and more obviously higher in diabetes with diabetic retinopathy, showing certain clinical and practical value.%　　目的探讨2型糖尿病视网膜病变与血清脂蛋白(a)的关系及其临床意义。方法检测了40例2型糖尿病患者的视网膜情况。按DR分期标准将该40例患者分为糖尿病正常眼底、糖尿病视网膜病变组（糖尿病DR组）各20例，并设正常对照组20例。测定了三组人群的血清Lp(a)水平，同时测定了三组人群的TC、LDL-c、HDL-c和TG水平，分析了其与血清Lp(a)的相关性。结果糖尿病正常眼底组apoB、TG、TC、LDL、Lp(a)水平较健康对照组升高，HDL-C降低，有显著性差异（P<0.05）；糖尿病DR组apoB、TC、LDL、Lp(a)较NIDDM组正常眼底组明显升高，HDL-C、ApoA1降低，有显著性差异（P<0.05），TG水平无显著性差异。扣除其他因素影响，Lp(a)与TC(r=0.773，P<0.05)、LDL(r=0.784，P<0.05)均呈正相关，Lp(a)与ApoAI、ApoB、TG、LDL-C无相关性。结论 Lp(a)水平在糖尿病DR组明显升高糖尿病正常眼底组，提示Lp(a)水平可能是2型糖尿病视网膜病变发生和加重的重要因素。