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目的探讨单核细胞趋化蛋白-1(MCP-1)和超敏C反应蛋白(Hs-CRP)等细胞因子水平的变化在2型糖尿病视网膜病变(DR)发病机理中的作用。方法选择2型糖尿病合并白内障并已行白内障超声乳化手术或超声乳化联合玻璃体切割术患者164例,根据眼底情况分为无视网膜病变组(NDR)55例、背景期DR组(BDR)53例和增殖期DR组(PDR)56例,并收集同期的非糖尿病白内障手术患者即对照组50例,各组患者年龄、性别分布的差异均无统计学意义。所有患者于术前采集血液和术中抽取未稀释的房水,分别采用ELISA法检测血液和房水中MCP-1和Hs-CRP的浓度并进行组间比较。结果患者各组血液及房水中MCP-1和Hs-CRP含量明显高于对照组P<0.01,组间有非常显著差异P<0.01,且随着病程的进展升高明显P<0.01。MCP-1和Hs-CRP水平均有一定增长趋势,且两指标呈正相关(无视网膜病变组r=0.675,背景期DR组r=0.823,增殖期DR组r=0.756,P<0.01)。结论糖尿病患者血液及房水中MCP-1和Hs-CRP与DR的严重程度密切相关,MCP-1和HsCRP在DR的损伤机制中有协同作用,对2型糖尿病视网膜病变患者的免疫机制和指导治疗有指导意义。
Objective To investigate the role of cytokines such as monocyte chemotactic protein-1 (MCP-1) and hypersensitive C-reactive protein (Hs-CRP) in the pathogenesis of type 2 diabetic retinopathy (DR). Methods One hundred and sixty-four patients with type 2 diabetes mellitus complicated with cataract who underwent phacoemulsification or phacoemulsification combined with vitrectomy were divided into 55 cases without retinopathy (retinopathy of retinal degeneration group), 53 cases with background DR group (BDR) 56 cases of proliferative phase DR group (PDR) and 50 cases of non-diabetic cataract surgery control group were collected in the same period. There was no significant difference in age and sex distribution between the two groups. All patients underwent preoperative blood collection and intraoperative extraction of undiluted aqueous humor. The concentrations of MCP-1 and Hs-CRP in blood and aqueous humor were detected by ELISA and compared between groups. Results The levels of MCP-1 and Hs-CRP in blood and aqueous humor in each group were significantly higher than those in the control group (P <0.01). There was a significant difference between the two groups (P <0.01), and the level of MCP-1 and Hs- The levels of MCP-1 and Hs-CRP showed a trend of increase with a positive correlation between the two indexes (r = 0.675 in the absence of retinopathy, r = 0.823 in the background DR group and r = 0.756 in the proliferative DR group, P <0.01). Conclusions MCP-1 and Hs-CRP are closely related to the severity of DR in the blood and aqueous humor of patients with diabetes mellitus. MCP-1 and HsCRP have a synergistic effect on the mechanism of DR injury, and the immune mechanism and guidance of patients with type 2 diabetic retinopathy Instructive.