2型糖尿病患者糖尿病视网膜病变不同时期血浆钙卫蛋白水平的检测与分析

发布时间：2018-03-17 07:47

本文选题：2型糖尿病　切入点：糖尿病视网膜病变　出处：《南京医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：背景糖尿病视网膜病变（DR）时视网膜血管的中性粒细胞浸润，造成血管内皮损伤。钙卫蛋白主要存在于中性粒细胞溶酶体外的细胞质中，通过促进中性粒细胞的聚集参与血管损伤的生物学行为，是一种潜在的临床炎症标志物。钙卫蛋白在DR进展过程中的作用尚不清楚。目的1.测定钙卫蛋白在糖尿病视网膜病变患者外周血中的表达水平，探讨其在糖尿病视网膜病变发病机制中的作用。2.分别测定钙卫蛋白在非增生型及增生型糖尿病视网膜病变患者外周血中的表达水平，了解其有无差异性，探讨其在糖尿病视网膜病变病情严重程度中的作用。方法本研究为病例对照研究。病例来源于南京医科大学附属无锡第二医院眼科门诊及住院患者。临床确诊为2型糖尿病的患者60例纳入研究，根据裂隙灯前置镜下眼底表现和荧光素眼底血管造影（FFA）检查结果将患者分为无糖尿病视网膜病变（NDR）组（20例）、非增生型糖尿病视网膜病变（NPDR）组（20例）和PDR组（20例），并纳入门诊体检的20例健康者为对照组，对照组与2型糖尿病组受检者的年龄、性别及血液生化检测指标结果相匹配。于清晨抽取受试者空腹静脉血2ml，双抗体夹心酶联免疫吸附测定法定量检测各组受检者血浆钙卫蛋白的质量浓度。所有资料输入计算机，采用SPSS18.0统计软件进行分析，计算资料所得数据以平均数±标准差（以x±s表示）表示，4个组受检者性别的差异比较采用!2检验；4个组受检者年龄、病程、空腹血糖浓度、糖化血红蛋白含量的差异比较采用单因素方差分析；4个组受检者的外周血中性粒细胞数量、白细胞数量、钙卫蛋白质量浓度的差异比较采用单因素方差分析，各指标组间两两比较采用SNK-q检验，钙卫蛋白质量浓度与中性粒细胞含量的相关性采用Pearson积矩相关分析。P0.05为差异有统计学意义。结果对照组、无DR组、NPDR组和PDR组受检者外周血浆中钙卫蛋白的质量浓度分别为（57.70±12.29）、（72.07±10.14）、（87.70±10.37）、（94.36±9.40） ng/L，4个组间的总体差异有统计学意义（F=73.09，，P0.01）。PDR组受检者外周血钙卫蛋白的质量浓度最高，与其他3个组间的两两比较差异均有统计学意义（q=20.157、10.648、4.497，P0.01）；NPDR组受检者外周血钙卫蛋白的质量浓度高于无DR组，差异有统计学意义（q=6.216，P0.01）。钙卫蛋白质量浓度与外周血中性粒细胞数量间无明显相关性（r=0.052，P=0.659）。结论1.血浆钙卫蛋白质量浓度的变化可能在2型糖尿病患者DR的发生发展过程中起一定作用。2.血浆钙卫蛋白高表达可能在糖尿病视网膜病变的病程进展及病情严重程度中起着重要的促进作用。3.血浆钙卫蛋白质量浓度的测定可能作为一个潜在的有临床价值的炎症指标。
[Abstract]:Background in diabetic retinopathy (DRR), neutrophils infiltrate the retinal blood vessels, resulting in vascular endothelial damage. Calcitonin mainly exists in the cytoplasm outside the neutrophil lysosome. It is a potential clinical inflammatory marker to participate in the biological behavior of vascular injury by promoting neutrophil aggregation. The role of calcitonin in Dr progression is not clear. Objective 1. To determine the expression of calcitonin in peripheral blood of patients with diabetic retinopathy. To investigate its role in the pathogenesis of diabetic retinopathy. To determine the expression of calmodulin in peripheral blood of patients with non-proliferative and proliferative diabetic retinopathy, and to find out whether there is any difference between them. To explore its role in the severity of diabetic retinopathy. Methods this study was a case-control study. 60 patients with type 2 diabetes were included in the study, who came from the ophthalmological outpatient and inpatient of Wuxi second Hospital affiliated to Nanjing Medical University. According to the fundus findings under slit lamp anterior endoscopy and the results of fundus fluorescein angiography (FFAA), the patients were divided into two groups: 20 patients without diabetic retinopathy, 20 patients with nonproliferative diabetic retinopathy and 20 patients with PDR, and 20 patients with PDR were divided into two groups: non diabetic retinopathy group (n = 20), non proliferative diabetic retinopathy group (n = 20) and PDR group (n = 20). 20 healthy subjects were included in the outpatient physical examination as the control group. Age of subjects in control group and type 2 diabetes group, The results of sex and blood biochemical test were matched. In the morning, the fasting venous blood was extracted from the subjects 2 ml, and the mass concentration of plasma calmodulin was measured by double antibody sandwich enzyme linked immunosorbent assay (Elisa). All the data were input into the computer. SPSS18.0 statistical software was used to analyze, the calculated data were expressed as mean 卤standard deviation (x 卤s), and the sex differences of the four groups were compared. (2) the age, course of disease, fasting blood glucose concentration and glycosylated hemoglobin content in the four groups were compared by univariate ANOVA, the number of neutrophils and leukocytes in the peripheral blood of the four groups were analyzed. Single factor analysis of variance (ANOVA) was used to compare the difference of calcium and protein concentration, and SNK-q test was used to compare the two groups. The correlation between calcium and protein concentration and neutrophil content was analyzed by Pearson moment correlation analysis. P05 was statistically significant. Results in control group, NPDR group without Dr group and PDR group, the plasma calcitonin concentrations were 57.70 卤12.29, 72.07 卤10.14, 77.70 卤10.37, 94.36 卤9.40) ng / L, respectively. The overall difference among the four groups was statistically significant. Compared with the other three groups, there were significant differences between the two groups. There was a significant difference between the two groups. The mass concentration of serum calmodulin in the NPDR group was significantly higher than that in the non-Dr group, and that in the NPDR group was significantly higher than that in the non-Dr group. There was no significant correlation between the concentration of Ca 2 + protein and the number of peripheral blood neutrophils. The changes of plasma calcium and protein levels may play a role in the development of Dr in type 2 diabetes mellitus. 2. The high expression of plasma calcitonin may play an important role in the progression and progression of diabetic retinopathy. 2. The determination of plasma calcium and protein levels may be a potential clinical indicator of inflammation.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R774.1;R587.2

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