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目的 :探讨 2型糖尿病 (DM )患者血清多胺 (腐胺、精胺、精脒 )水平的变化及其临床意义。方法 :按照尿白蛋白的排泄率水平 (AER)将DM分为 3组。D1组 :AER <2 0 μg·min- 1,D2 组 :AER 2 0～ 2 0 0μg·min- 1,D3组AER >2 0 0 μg·min- 1;按照视网膜病变 (DR)的有无 ,将DM分为DR1组 (无DR)、DR2 组 (非增殖性视网膜病变 )、DR3组 (增殖性视网膜病变 )。多胺水平采用高效液相色谱法 (HPLC)测定 ,尿白蛋白采用RIA法测定 ,HbAlc采用亲合层析微柱法。结果 :DM患者多胺水平较正常对照组显著升高 (P <0 .0 5) ,多胺水平与logAER呈显著正相关 (P <0 .0 5) ,多胺水平在DR组显著升高 (P <0 .0 1)。 结论 :2型DM患者血清多胺水平升高与DN及DR的微血管病变密切相关 ,多胺水平可能对DN及DR的发生发展起一定作用。
Objective: To investigate the changes of serum polyamine (putrescine, spermine and spermidine) in patients with type 2 diabetes mellitus (DM) and its clinical significance. Methods: According to the level of urinary albumin excretion (AER) DM was divided into three groups. D1 group: AER <20 μg · min-1, D2 group: AER 20 ~ 200 μg · min-1, D3 group AER> 200 μg · min-1; according to the presence or absence of retinopathy (DR) DM was divided into DR1 group (without DR), DR2 group (nonproliferative retinopathy) and DR3 group (proliferative retinopathy). Polyamine levels were measured by high performance liquid chromatography (HPLC), urinary albumin by RIA method, HbAlc by affinity chromatography microcolumn method. Results: The levels of polyamine in DM patients were significantly higher than those in normal controls (P <0.05), the levels of polyamine were positively correlated with logAER (P <0.05), and the levels of polyamine in DR patients were significantly increased (P <0. 01). Conclusions: Elevated serum polyamines level is closely related to DN and DR microangiopathy in type 2 DM patients. Polyamine levels may play a role in the pathogenesis of DN and DR.