本文選題：糖尿病視網(wǎng)膜病變 + 胱抑素C�。� 參考：《西安醫(yī)學(xué)院》2017年碩士論文

【摘要】：研究目的:糖尿病視網(wǎng)膜病變(DR)是最為常見的糖尿病慢性微血管病變之一,早期無明顯自覺癥狀,病變發(fā)展到黃斑后開始出現(xiàn)不同程度的視力減退,最終導(dǎo)致不可逆性失明,是成年人中首位致盲性眼病。相較胱抑素C與糖尿病腎病的相關(guān)性研究,胱抑素C與2型糖尿病視網(wǎng)膜病變相關(guān)性的研究很少。本研究通過病例對(duì)照研究2型糖尿病患者中,以視網(wǎng)膜病變作為主要觀察指標(biāo),探討血清中胱抑素C含量是否能作為2型糖尿病視網(wǎng)膜病變的危險(xiǎn)因素。研究方法:選取2014年9月-2016年1月西安醫(yī)學(xué)院第二附屬醫(yī)院內(nèi)分泌科室住院并請(qǐng)眼科進(jìn)行會(huì)診的84名2型糖尿病患者及28名無2型糖尿病無視網(wǎng)膜病變體檢結(jié)果無明顯異常的正常人。仔細(xì)詢問患者病史及其相關(guān)資料,收集患者入院期間血生化檢查結(jié)果,所有入組病例行眼底照相檢查,必要時(shí)行眼底血管熒光造影檢查,2型糖尿病患者按是否存在視網(wǎng)膜病變分為NDR組(2型糖尿病不伴有視網(wǎng)膜病變患者)DR組(2型糖尿病患者伴視網(wǎng)膜病變患者),按視網(wǎng)膜病變程度將DR組分為NPDR組(2型糖尿病伴非增殖性視網(wǎng)膜病變)PDR組(2型糖尿病伴增殖性視網(wǎng)膜病變)兩組,28名體檢結(jié)果無異常的正常人作為對(duì)照組。采用SPSS 18.0軟件對(duì)所得數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,計(jì)量資料用((?)±S)表示,非正太分布的計(jì)量資料用中位數(shù)(四分位間距)表示,符合正太分布數(shù)據(jù)多樣本間比較用方差分析,不符合正態(tài)分布的數(shù)據(jù)多樣本之間用非參數(shù)檢驗(yàn),Spearman相關(guān)分析研究數(shù)據(jù)之間的關(guān)系,對(duì)胱抑素及各變量進(jìn)行l(wèi)ogistic多元逐步回歸分析,以P0.05為差異有統(tǒng)計(jì)學(xué)意義。研究結(jié)果:1.對(duì)照組、NDR組、NPDR組級(jí)PDR組的一般資料及抽血檢查結(jié)果比較顯示:各組的糖化血紅蛋白、總膽固醇、甘油三酯、尿素氮、肌酐、胱抑素C、病程的差異均有統(tǒng)計(jì)學(xué)意義(p0.05)。2.根據(jù)四分位法按胱抑素水平高低分組后,高血清胱抑素C水平組糖尿病視網(wǎng)膜病變的患病率明顯高于其他三組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。3.Spearman相關(guān)分析顯示:血清胱抑素C水平與糖化血紅蛋白、尿素氮及肌酐呈正相關(guān)(r=0.223;r=0.335;r=0.502)(p0.05),血清胱抑素水平與總膽固醇、甘油三酯、病程、年齡無相關(guān)性。4.Logistic回歸分析顯示:病程、血清胱抑素及糖化血紅蛋白為2型糖尿病視網(wǎng)膜病變的獨(dú)立危險(xiǎn)因素。研究結(jié)論:1.高血清胱抑素C水平組糖尿病視網(wǎng)膜病變的患病率明顯高于其他三組。2.血清胱抑素C是糖尿病視網(wǎng)膜病變的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: diabetic retinopathy (DRR) is one of the most common diabetic chronic microangiopathy. Is the first adult blinding eye disease. The correlation between cystatin C and diabetic nephropathy is less than that between cystatin C and type 2 diabetic retinopathy. The aim of this study was to investigate whether the level of cystatin C in serum was a risk factor for type 2 diabetic retinopathy by using retinopathy as the main observation index in a case-control study. Methods: from September 2014 to January 2016, 84 patients with type 2 diabetes mellitus and 28 patients without type 2 diabetes mellitus without retinopathy who were hospitalized in the Department of Endocrinology, second affiliated Hospital of Xi'an Medical College and asked for ophthalmic consultation were selected. A normal person without obvious abnormalities. Carefully ask the patient's medical history and related data, collect the results of the blood biochemical examination during admission, and all the incoming cases undergo fundus photography. Fundus fluorescein angiography was performed when necessary. According to the presence of retinopathy, patients with type 2 diabetes were divided into two groups: NDR group, type 2 diabetes mellitus without retinopathy group, Dr group, type 2 diabetic patients with retinopathy. According to the degree of retinopathy, Dr group was divided into two groups: type 2 diabetes mellitus with non-proliferative retinopathy (NPDR group) and type 2 diabetes mellitus with proliferative retinopathy (NPDR group). SPSS 18.0 software was used to analyze the data, and the measurement data was expressed by the mean of the median (quartile spacing). The variance analysis was used to compare the data in accordance with the data of the distribution of the positive and too many samples, and the non-positive distribution was expressed as the median (quartile spacing). Non-parametric test was used to study the relationship between multiple samples of non-normal distribution data. The logistic stepwise regression analysis of cystatin and its variables was carried out, and the difference was statistically significant (P0.05). The result of the study was: 1. The general data and blood samples of PDR group in control group were compared. The results showed that there were significant differences in glycosylated hemoglobin, total cholesterol, triglyceride, urea nitrogen, creatinine, cystatin C and course of disease in each group. The prevalence of diabetic retinopathy in the high serum cystatin C group was significantly higher than that in the other three groups. Spearman correlation analysis showed that there was a positive correlation between serum cystatin C level and glycosylated hemoglobin, urea nitrogen and creatinine, serum cystatin level and total cholesterol, triglyceride, course of disease. Logistic regression analysis showed that the course of disease, serum cystatin and glycosylated hemoglobin were independent risk factors for type 2 diabetic retinopathy. Conclusion: 1. The prevalence of diabetic retinopathy in high serum cystatin C group was significantly higher than that in other three groups. Serum cystatin C is an independent risk factor for diabetic retinopathy.
【學(xué)位授予單位】：西安醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.2;R774.1

【參考文獻(xiàn)】

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