AIM; To investigate the association of homocysteine (Hey) levels in plasma and tear with ocular surface damage in the patients with type 2 diabetes. METHODS; The plasma and tear levels of Hey in 40 patients with type 2 diabetes and 40 age - and sex - matched normal controls were measured by high - performance liquid chromatography with fluorescence detection (HPLC - FD). These 40 diabetic patients (80 eyes) and 40 normal controls (80 eyes) received fundus fluorescence angiography, determination of cornea] sensitivity, basic tear secretion assay, tear film breakup time test, comeal fluorescein staining and conjunctival rose bengal staining. All the results were quantified and analyzed by SPSS 13. 0 statistical analysis software. RESULTS; It was the first time that Hey had been detected in tear.' The plasma and tear levels of Hey in diabetic patients were significantly higher than those in controls ( P <0.01). The concentration of Hcy increased both in plasma and tear with the severity of diabetic retinopathy ( P < 0. 01). A statistically significant correlation between tear Hey concentration and diabetic ocular surface diseases was observed. CONCLUSION; The raise of Hcy level in tear and plasma of the diabetic patients may be involved in the occurrence of diabetic ocular surface damage.%目的:分析2型糖尿病患者泪液与血浆中同型半胱氨酸(Hcy)水平及其与糖尿病性眼表损害间的联系,探讨糖尿病所致眼表损害的可能致病因素.方法:按照诊断标准,选取我院确诊并住院的2型糖尿病性眼表损害患者40例,其中男21例,女19例,共80只眼,年龄45-75岁,平均(58.68±7.33)岁;以性别、年龄为匹配因素,同期选取我院体检的正常健康人40例为对照组.以高效液相色谱分析+荧光检测法分别测定各组患者血浆、泪液Hcy水平,并进行眼底荧光血管造影、角膜敏感度测定、基础泪液分泌量测定、泪膜破裂时间检测、角膜荧光素染色及结膜虎红染色.结果:首次在泪液中检测出Hcy.2型糖尿病眼表损害患者血浆和泪液中Hcy含量均高于正常对照组(均P<0.01),且两者呈正相关(P<0.01);均随糖尿病视网膜病变程度加重而升高(P<0.01),并与糖尿病眼表损害程度呈正相关.结论:泪液与血浆中Hcy含量升高可能在糖尿病性眼表损害的发生机制中发挥了重要作用.
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