探讨同型半胱氨酸血脂及血液流变学在糖尿病视网膜病变中的意义

摘要

目的：探讨同型半胱氨酸（HCY ）、血脂及血液流变学在糖尿病视网膜病变患者中的变化及临床意义。方法121例糖尿病患者，其中有视网膜病变组52例，无视网膜病变组69例，另设健康对照组50例，进行HCY、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）及血液流变学各项指标检测。结果（1）与健康对照组比较，糖尿病两组患者 HCY、FBG、HbA1c、TC、TG、LDL-C和血液流变学各项指标均明显升高（P＜0．01）；（2）糖尿病视网膜病变组 HCY、HbA1c、TC、TG、LDL-C和血液流变学各项指标明显高于无视网膜病变组（P＜0．01）；（3）各组 HDL-C比较，差异无统计学意义（P＞0．05）。结论糖尿病视网膜病变患者存在高 HCY血症、脂代谢紊乱和血液流变学异常，检测糖尿病患者 HCY、血脂及血液流变学指标的变化有助于早期发现糖尿病患者视网膜病变。%Objective To investigate the clinical significance of homocysteine(HCY) ,lipid and blood rheology indicator in patients with diabetic retinopathy .Methods A total of 121 patients with diabetes were divided into dia-betic retinopathy group(52 cases) and non-diabetic retinopathy group (69 cases) ,and 50 cases of healthy subjects were enrolled as control group .HCY ,fasting blood glucose(FBG) ,glycosylated hemoglobin(HbA1c) ,total cholester-ol(TC) ,triacylglycerol(TG) ,low density lipoprotein cholesterol(LDL-C) ,high density lipoprotein cholesterol(HDL-C) and blood rheology indexes were detected in all groups .Results (1)Compared with control group ,levels of HCY , FBG ,HbA1c ,TC ,TG ,LDL-C and blood rheology indexes in diabetic retinopathy group and non-diabetic retinopathy group were obviously higher(P<0 .01) .(2)Compared with non-diabetic retinopathy group ,levels of HCY ,HbA1c , TC ,TG ,LDL-C and blood rheology indexes in diabetic retinopathy group were obviously higher (P<0 .01) .(3)The difference of HDL-C level between each group were not significant (P>0 .05) .Conclusion Patients with Diabetic retinopathy might be with hyperhomocystinemia ,metabolic disorder of lipid and abnormal blood rheology ,and detec-tion of HCY ,blood lipid and blood rheology indexes could contribute to early diagnosis of diabetic retinopathy .