【摘要】 目的:探讨血清胆红素水平与2型糖尿病(T2DM)视网膜病变(DR)的关系。方法:选取2016年1月至2017年12月广西医科大学第三附属医院收治的180例T2DM患者,分为3组:无DR组(NDR组)、非增生期DR组(NPDR组)及增生期DR组(PDR组),每组60例。另选取在本院行体格检查的60例健康志愿者作为对照组。记录研究对象血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、血红蛋白(HB)、糖化血红蛋白(HBa1C)、尿酸(UA)水平等生化指标水平。采用多因素Logistic回归分析方法分析DR发生、发展的影响因素。结果:与对照组比较,NPDR组和PDR组血清TBIL、IBIL、HB、TG、LDL水平显著下降(P<0.05),FBG、2 h PBG、HBa1C水平明显升高(P<0.05);与NDR组比较,NPDR组和PDR组血清TBIL、DBIL、IBIL、HB水平显著下降,且PDR组血清IBIL、HB、HBa1C水平低于NPDR组(P<0.05)。PDR组UA水平显著高于对照组和NDR组(P<0.05)。有序Logistic回归分析结果显示:TBIL、IBIL、HB、FBG、HBa1C为DR发生、发展的保护因素(OR=0.491、0.417、0.975、0.928、0.883,均P<0.05),而UA可能为DR发生、发展的危险因素(OR=1.003,P<0.05)。结论:血清TBIL、IBIL可能在DR的发生、发展中起到保护性作用。更多还原

【Abstract】 Objective:To investigate the correlation between serum bilirubin level and type 2 diabetic retinopathy(DR).Methods:From January 2016 to December 2017,180 type 2 diabetes patients in our hospital were selected,and divided into 3 groups:NDR group(patients without DR),NPDR group(patients with non-proliferative DR) and PDR group(patients with proliferative DR),with 60 cases in each group.60 healthy volunteers who underwent physical examination in our hospital were selected as a control group.The serum total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),hemoglobin(HB),glycosylated hemoglobin(HBa1 C) and uric acid(UA) levels were recorded.The influence factors of DR occurrence and development were analyzed by multiple logistic regression analysis.Results:Compared with the control group,the serum TBIL,IBIL,HB and HBa1 C levels in NPDR group and PDR group were significantly lower than those in the control group(P<0.05).Compared with NDR group,the serum TBIL,DBIL,IBIL and HB levels in NPDR group and PDR group were significantly lower than those in NPDR group,and the serum IBIL,HB and HBa1 C levels in PDR group were lower than those in NPDR group(P<0.05).The level of UA in PDR group was significantly higher than that in control group and NDR group(P<0.05).Multiple logistic regression analysis showed that TBIL,IBIL,HB,FBG and HBa1 C was the protective factor for the occurrence and development of DR(OR=0.491,0.417,0.975,0.928 and 0.883,P<0 05),and UA might be a risk factor for the occurrence and development of DR(OR=1.003,P<0 05).Conclusion:Serum TBIL and IBIL might play a protective role in the development of DR.更多还原