目的 探究糖尿病不同程度微血管病变的患者中血清炎性因子、血浆同型半胱氨酸(homocysteine,Hcy)和血液流变学指标的变化.方法 随机选取笔者医院于2013年1月～ 2015年7月收治的2型糖尿病患者180例,按照视网膜病变程度分为3组:糖尿病无视网膜病变(no diabetic retinopathy,NDR)组60例,背景型糖尿病视网膜病变(background diabetic retinopathy,BDR)组60例,增殖型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)组60例,比较3组患者血清中高敏C反应蛋白(hypersensitive c-reactive protein,hs-CRP)、白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)水平、血浆Hcy水平以及血液流变学指标.结果 BDR组和PDR组患者血清中hs-CRP、IL-6、TNF-α水平、血浆Hcy水平以及血液流变学指标均明显高于NDR组,差异有统计学意义(P ＜0.05);PDR组患者血清中hs-CRP、IL-6、TNF-α水平、血浆Hcy水平以及血液流变学指标均明显高于BDR组(P＜0.05).结论 糖尿病患者随着病情进展,包括hs-CRP、IL-6、TNF-α在内的血清炎性因子、Hcy以及血液流变学指标不断增高,可能与视网膜病变的发生发展过程有关.%Objective To explore the changes in serum inflammatory cytokines,plasma homocysteine (Hcy) and hemorheology in patients with diabetic microangiopathy of different severity.Methods A total of 180 T2DM patients admitted to our hospital from January 2013 to July 2015 were selected and randomized into either the no diabetic retinopathy (NDR) group,background diabetic retinopathy (BDR) group or proliferative diabetic retinopathy (PDR) group,each including 60 patients.We compared serum hypersensitive c-reactive protein (hs-CRP),interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) levels,plasma Hcy level,and hemorheological indicators across the three groups.Results Serum hs-CRP,IL-6 and TNF-α levels,plasma Hcy level and hemorheological indicators were all significantly higher in BDR and PDR groups than in NDR group,with statistically significant differences (P ＜ 0.05).Serum hs-CRP,IL-6 and TNF-αt levels,plasma Hcy level and hemorheological indicators were all significantly higher in PDR group than in BDR group,with statistically significant differences (P ＜ 0.05).Conclusion Serum hs-CRP,IL-6 and TNF-α levels,plasma Hcy level and hemorheological indicators would raise constantly with disease progression in diabetic patients,which might be associated with the development and progression of retinopathy.
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