本文選題：2型糖尿病　切入點：糖尿病視網(wǎng)膜病變　出處：《南京醫(yī)科大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：背景糖尿病視網(wǎng)膜病變（DR）時視網(wǎng)膜血管的中性粒細(xì)胞浸潤，造成血管內(nèi)皮損傷。鈣衛(wèi)蛋白主要存在于中性粒細(xì)胞溶酶體外的細(xì)胞質(zhì)中，通過促進(jìn)中性粒細(xì)胞的聚集參與血管損傷的生物學(xué)行為，是一種潛在的臨床炎癥標(biāo)志物。鈣衛(wèi)蛋白在DR進(jìn)展過程中的作用尚不清楚。 目的1.測定鈣衛(wèi)蛋白在糖尿病視網(wǎng)膜病變患者外周血中的表達(dá)水平，探討其在糖尿病視網(wǎng)膜病變發(fā)病機制中的作用。2.分別測定鈣衛(wèi)蛋白在非增生型及增生型糖尿病視網(wǎng)膜病變患者外周血中的表達(dá)水平，了解其有無差異性，探討其在糖尿病視網(wǎng)膜病變病情嚴(yán)重程度中的作用。 方法本研究為病例對照研究。病例來源于南京醫(yī)科大學(xué)附屬無錫第二醫(yī)院眼科門診及住院患者。臨床確診為2型糖尿病的患者60例納入研究，根據(jù)裂隙燈前置鏡下眼底表現(xiàn)和熒光素眼底血管造影（FFA）檢查結(jié)果將患者分為無糖尿病視網(wǎng)膜病變（NDR）組（20例）、非增生型糖尿病視網(wǎng)膜病變（NPDR）組（20例）和PDR組（20例），并納入門診體檢的20例健康者為對照組，對照組與2型糖尿病組受檢者的年齡、性別及血液生化檢測指標(biāo)結(jié)果相匹配。于清晨抽取受試者空腹靜脈血2ml，雙抗體夾心酶聯(lián)免疫吸附測定法定量檢測各組受檢者血漿鈣衛(wèi)蛋白的質(zhì)量濃度。所有資料輸入計算機，采用SPSS18.0統(tǒng)計軟件進(jìn)行分析，計算資料所得數(shù)據(jù)以平均數(shù)±標(biāo)準(zhǔn)差（以x±s表示）表示，4個組受檢者性別的差異比較采用!2檢驗；4個組受檢者年齡、病程、空腹血糖濃度、糖化血紅蛋白含量的差異比較采用單因素方差分析；4個組受檢者的外周血中性粒細(xì)胞數(shù)量、白細(xì)胞數(shù)量、鈣衛(wèi)蛋白質(zhì)量濃度的差異比較采用單因素方差分析，各指標(biāo)組間兩兩比較采用SNK-q檢驗，鈣衛(wèi)蛋白質(zhì)量濃度與中性粒細(xì)胞含量的相關(guān)性采用Pearson積矩相關(guān)分析。P0.05為差異有統(tǒng)計學(xué)意義。 結(jié)果對照組、無DR組、NPDR組和PDR組受檢者外周血漿中鈣衛(wèi)蛋白的質(zhì)量濃度分別為（57.70±12.29）、（72.07±10.14）、（87.70±10.37）、（94.36±9.40） ng/L，4個組間的總體差異有統(tǒng)計學(xué)意義（F=73.09，，P0.01）。PDR組受檢者外周血鈣衛(wèi)蛋白的質(zhì)量濃度最高，與其他3個組間的兩兩比較差異均有統(tǒng)計學(xué)意義（q=20.157、10.648、4.497，P0.01）；NPDR組受檢者外周血鈣衛(wèi)蛋白的質(zhì)量濃度高于無DR組，差異有統(tǒng)計學(xué)意義（q=6.216，P0.01）。鈣衛(wèi)蛋白質(zhì)量濃度與外周血中性粒細(xì)胞數(shù)量間無明顯相關(guān)性（r=0.052，P=0.659）。 結(jié)論1.血漿鈣衛(wèi)蛋白質(zhì)量濃度的變化可能在2型糖尿病患者DR的發(fā)生發(fā)展過程中起一定作用。2.血漿鈣衛(wèi)蛋白高表達(dá)可能在糖尿病視網(wǎng)膜病變的病程進(jìn)展及病情嚴(yán)重程度中起著重要的促進(jìn)作用。3.血漿鈣衛(wèi)蛋白質(zhì)量濃度的測定可能作為一個潛在的有臨床價值的炎癥指標(biāo)。
[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 鹵standard deviation (x 鹵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 鹵12.29, 72.07 鹵10.14, 77.70 鹵10.37, 94.36 鹵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.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R774.1;R587.2

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