几丁质酶3样蛋白1与糖尿病视网膜病变的相关性研究

发布时间：2018-05-28 05:07

  本文选题：几丁质酶3样蛋白1 + 糖尿病视网膜病变　； 参考：《华北理工大学》2017年硕士论文

【摘要】：目的通过检测2型糖尿病合并糖尿病视网膜病变患者血清几丁质酶3样蛋白1、血糖、血脂等的水平变化,分析糖尿病视网膜病变的危险因素,探讨几丁质酶3样蛋白1、血糖、血脂等与糖尿病视网膜病变的关系,为临床早期诊断和治疗糖尿病视网膜病变提供依据。方法选取2015年12月~2016年12月在华北理工大学附属医院内分泌科住院的122例2型糖尿病患者作为研究对象。将所有研究对象依据眼底照相及荧光眼底血管造影分为糖尿病视网膜病变组(DR组)77例,单纯2型糖尿病组(DM组)45例作为对照组。其中DR组包括非增殖型糖尿病视网膜病变组(NPDR组)45例,增殖型糖尿病视网膜病变组(PDR组)32例。对所有研究对象进行性别、年龄、病程、身高、体重等基础数据记录和测量,计算体重指数(BMI)。测定收缩压(SBP)、舒张压(DBP)、空腹静脉血糖(FPG)、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、空腹C肽(FC)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、尿微量白蛋白(UAlb)、超敏C反应蛋白(hs-CRP)、几丁质酶3样蛋白1(YKL-40)水平,并计算胰岛素抵抗指数(HOMA-IR)。拟定调查表,整理资料并进行录入,对收集的数据运用SPSS23.0统计软件进行分析,计量资料用均数±标准差((?)±s)表示,计数资料采用c2检验,两组间均数比较采用t检验;糖尿病视网膜病变危险因素分析采用多因素非条件Logistic回归分析,P0.05表明有统计学意义。应用Pearson相关系数及多元逐步回归方法对YKL-40水平与其它指标的关系进行分析。结果1两组间性别构成经c2检验差异无统计学意义(P0.05),说明本研究性别构成存在可比性。2两组间年龄、BMI、DBP、FINS、FC经t检验比较差异无统计学意义(P0.05)。3 DR组病程、SBP、FPG、Hb A1c、HOMA-IR、TC、TG、LDL-C、hs-CRP、UA1b高于DM组,DR组HDL-C低于DM组,差异有统计学意义(P0.05)。4 DR组YKL-40水平高于DM组,并随糖尿病视网膜病变严重程度增加而升高,差异有统计学意义(P0.05)。YKL-40≥118ng/ml时,T2DM患者合并DR的风险增加16.64倍。YKL-40≥157 ng/ml时,NPDR患者发展为PDR的风险增加21.63倍。5以是否患有糖尿病视网膜病变为因变量,以t检验有统计学差异的指标为自变量,开展多因素非条件Logistic回归分析,结果表明糖尿病视网膜病变与病程、Hb A1c、YKL-40、UAlb呈正相关(P0.05)。6以YKL-40为因变量的相关分析显示,YKL-40与Hb A1c、病程、UA1b、hs-CRP、FPG、TG、LDL-C、TC、HOMA-IR、SBP呈正相关(P0.05),与HDL-C呈负相关(P0.05);以YKL-40为因变量,以病程、SBP、FPG、Hb A1c、HOMA-IR、TC、TG、HDL-C、LDL-C、hs-CRP、UAlb为自变量进行多元逐步回归分析。YKL-40与病程、Hb A1c、hs-CRP、UA1b正相关(P0.05),与HDL-C负相关(P0.05)。结论1糖尿病视网膜病变患者血清YKL-40水平高于单纯2型糖尿病患者,YKL-40水平随糖尿病视网膜病变严重程度增加而升高。2血清YKL-40水平与糖尿病视网膜病变发生发展有关,YKL-40水平升高,糖尿病视网膜病变发生及进展的危险性增加。
[Abstract]:Objective to analyze the risk factors of diabetic retinopathy by detecting the changes of serum chitinase 3 like protein 1, blood glucose and blood lipids in patients with type 2 diabetes mellitus complicated with diabetic retinopathy, and to explore the level of chitinase 3 like protein 1 and blood sugar. The relationship between serum lipids and diabetic retinopathy provides evidence for early diagnosis and treatment of diabetic retinopathy. Methods 122 patients with type 2 diabetes were selected from December 2015 to December 2016 in the Endocrinology Department of affiliated Hospital of North China University of Technology. According to fundus photography and fluorescence fundus angiography, all subjects were divided into diabetic retinopathy group (n = 77) and type 2 diabetic group (n = 45). Dr group included 45 cases of NPDR group and 32 cases of PDR group. The basic data of sex, age, course of disease, height and weight were recorded and measured to calculate the body mass index (BMI). Determination of systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting venous blood glucose (FPG), glycosylated hemoglobin (HbA1cN), fasting insulin (FINSN), fasting C-peptide (FCN), total cholesterol (TC), triglyceride (TGN), high density lipoprotein (HDL-C), low density lipoprotein (LDL-CU), urinary albumin (UAlb), hypersensitive C (C) Reactive protein hs-CRPN, chitinase 3-like protein 1 (YKL-40), The insulin resistance index was calculated. The data collected were analyzed by SPSS23.0 software. The measurement data were expressed with mean 卤standard deviation (卤s). The counting data were measured by c2 test, and t test was used for the comparison between the two groups. The risk factors of diabetic retinopathy were analyzed by multivariate non-conditional Logistic regression analysis (P0.05). Pearson correlation coefficient and multivariate stepwise regression were used to analyze the relationship between YKL-40 level and other indexes. Results (1) there was no significant difference in sex composition between the two groups by c2 test (P 0.05), which indicated that the sex composition of this study was comparable between two groups. 2 there was no significant difference in HDL-C between the two groups by t test. There was no significant difference between the two groups in course of disease (P 0.053.DR group). The HDL-C of TGLDL-CS-CRPUA1b was higher than that of DM group (P < 0.05). The level of YKL-40 in P0.054-DR group was higher than that in DM group, and increased with the severity of diabetic retinopathy. There was a statistically significant difference in the risk of developing to PDR in patients with T2DM with P0.05U. YKL-40 鈮，

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