本文選題：幾丁質(zhì)酶3樣蛋白1 + 糖尿病視網(wǎng)膜病變��； 參考：《華北理工大學(xué)》2017年碩士論文

【摘要】：目的通過檢測2型糖尿病合并糖尿病視網(wǎng)膜病變患者血清幾丁質(zhì)酶3樣蛋白1、血糖、血脂等的水平變化,分析糖尿病視網(wǎng)膜病變的危險因素,探討幾丁質(zhì)酶3樣蛋白1、血糖、血脂等與糖尿病視網(wǎng)膜病變的關(guān)系,為臨床早期診斷和治療糖尿病視網(wǎng)膜病變提供依據(jù)。方法選取2015年12月~2016年12月在華北理工大學(xué)附屬醫(yī)院內(nèi)分泌科住院的122例2型糖尿病患者作為研究對象。將所有研究對象依據(jù)眼底照相及熒光眼底血管造影分為糖尿病視網(wǎng)膜病變組(DR組)77例,單純2型糖尿病組(DM組)45例作為對照組。其中DR組包括非增殖型糖尿病視網(wǎng)膜病變組(NPDR組)45例,增殖型糖尿病視網(wǎng)膜病變組(PDR組)32例。對所有研究對象進(jìn)行性別、年齡、病程、身高、體重等基礎(chǔ)數(shù)據(jù)記錄和測量,計算體重指數(shù)(BMI)。測定收縮壓(SBP)、舒張壓(DBP)、空腹靜脈血糖(FPG)、糖化血紅蛋白(Hb A1c)、空腹胰島素(FINS)、空腹C肽(FC)、總膽固醇(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反應(yīng)蛋白(hs-CRP)、幾丁質(zhì)酶3樣蛋白1(YKL-40)水平,并計算胰島素抵抗指數(shù)(HOMA-IR)。擬定調(diào)查表,整理資料并進(jìn)行錄入,對收集的數(shù)據(jù)運(yùn)用SPSS23.0統(tǒng)計軟件進(jìn)行分析,計量資料用均數(shù)±標(biāo)準(zhǔn)差((?)±s)表示,計數(shù)資料采用c2檢驗(yàn),兩組間均數(shù)比較采用t檢驗(yàn);糖尿病視網(wǎng)膜病變危險因素分析采用多因素非條件Logistic回歸分析,P0.05表明有統(tǒng)計學(xué)意義。應(yīng)用Pearson相關(guān)系數(shù)及多元逐步回歸方法對YKL-40水平與其它指標(biāo)的關(guān)系進(jìn)行分析。結(jié)果1兩組間性別構(gòu)成經(jīng)c2檢驗(yàn)差異無統(tǒng)計學(xué)意義(P0.05),說明本研究性別構(gòu)成存在可比性。2兩組間年齡、BMI、DBP、FINS、FC經(jīng)t檢驗(yàn)比較差異無統(tǒng)計學(xué)意義(P0.05)。3 DR組病程、SBP、FPG、Hb A1c、HOMA-IR、TC、TG、LDL-C、hs-CRP、UA1b高于DM組,DR組HDL-C低于DM組,差異有統(tǒng)計學(xué)意義(P0.05)。4 DR組YKL-40水平高于DM組,并隨糖尿病視網(wǎng)膜病變嚴(yán)重程度增加而升高,差異有統(tǒng)計學(xué)意義(P0.05)。YKL-40≥118ng/ml時,T2DM患者合并DR的風(fēng)險增加16.64倍。YKL-40≥157 ng/ml時,NPDR患者發(fā)展為PDR的風(fēng)險增加21.63倍。5以是否患有糖尿病視網(wǎng)膜病變?yōu)橐蜃兞?以t檢驗(yàn)有統(tǒng)計學(xué)差異的指標(biāo)為自變量,開展多因素非條件Logistic回歸分析,結(jié)果表明糖尿病視網(wǎng)膜病變與病程、Hb A1c、YKL-40、UAlb呈正相關(guān)(P0.05)。6以YKL-40為因變量的相關(guān)分析顯示,YKL-40與Hb A1c、病程、UA1b、hs-CRP、FPG、TG、LDL-C、TC、HOMA-IR、SBP呈正相關(guān)(P0.05),與HDL-C呈負(fù)相關(guān)(P0.05);以YKL-40為因變量,以病程、SBP、FPG、Hb A1c、HOMA-IR、TC、TG、HDL-C、LDL-C、hs-CRP、UAlb為自變量進(jìn)行多元逐步回歸分析。YKL-40與病程、Hb A1c、hs-CRP、UA1b正相關(guān)(P0.05),與HDL-C負(fù)相關(guān)(P0.05)。結(jié)論1糖尿病視網(wǎng)膜病變患者血清YKL-40水平高于單純2型糖尿病患者,YKL-40水平隨糖尿病視網(wǎng)膜病變嚴(yán)重程度增加而升高。2血清YKL-40水平與糖尿病視網(wǎng)膜病變發(fā)生發(fā)展有關(guān),YKL-40水平升高,糖尿病視網(wǎng)膜病變發(fā)生及進(jìn)展的危險性增加。
[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 鹵standard deviation (鹵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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