目的　探讨瘦素、内皮素 (ET)、一氧化氮 (NO)在糖尿病视网膜病变 (DR)发生、发展中的作用。方法 :采用酶联免疫吸附法分别测定 5 4例糖尿病患者 (DM)和 4 4名健康志愿者 (对照组 )血中瘦素含量 ,对 DM组行直接放射免疫法、硝酸还原酶法分别测定血 ET和 N O的含量 ,比较并分析其相关关系。结果 :1血清瘦素含量患者组 (13± 4 ) μg/ L 较对照组 (6± 4 ) μg/ L 显著升高 (P<0 .0 0 1) ;非增生性视网膜病 (BDR)组 (16± 6 ) μg/ L 较无视网膜病 (NDR)组 (7± 4 ) μg/ L 显著升高 (P<0 .0 5 ) ;增生性视网膜病 (PDR)组 (40± 8) μg/ L 较 BDR组 (16±6 ) μg/ L 显著升高 (P<0 .0 1)。 2随病程的进展患者组血 NO含量显著下降 (P=0 .0 0 13)且血 ET含量显著升高(P<0 .0 0 1)。 3直线相关分析表明 DR患者血清瘦素含量与血浆 ET含量呈正相关 (r=0 .80 4 ,P<0 .0 0 0 1) ,与血清 NO水平呈负相关 (r=- 0 .779,P<0 .0 0 0 1)。结论　 DR患者血清瘦素含量升高可提示 DR病变的严重程度 ,其升高与 ET呈正相关而与 NO呈负相关 ,表明视网膜缺血 ,而且其升高可能诱导 DR患者新生血管生成 ,为DR的早期干预治疗提供了新思路 Objective To investigate the role of leptin, endothelin (ET) and nitric oxide (NO) in the occurrence and development of diabetic retinopathy (DR). Methods: The levels of leptin in 54 DM patients and 44 healthy volunteers (control group) were determined by enzyme-linked immunosorbent assay (ELISA). The levels of leptin in DM group were measured by direct radioimmunoassay and nitrate reductase Blood ET and NO content, compare and analyze the correlation. Results: Serum leptin levels were significantly higher in patients with leptin than those in controls (13 ± 4) μg / L (6 ± 4) μg / L, P <0.01. In non-proliferative retinopathy (16 ± 6) μg / L were significantly higher than those without retinopathy (7 ± 4) μg / L (P <0.05); proliferative retinopathy (40 ± 8) μg / L was significantly higher than that of BDR group (16 ± 6) μg / L (P <0.01). 2 As the course of disease progressed, the blood level of NO was significantly decreased (P = 0.013) and the content of blood ET was significantly increased (P <0.01). 3 linear correlation analysis showed that serum leptin levels in patients with DR and plasma ET levels were positively correlated (r = 0.804, P <0.0001), and serum NO levels was negatively correlated (r = -0.7779, P <0 0 0 1). Conclusion Serum leptin levels in DR patients may indicate the severity of DR. The positive correlation between the level of leptin and DR is negatively correlated with ET, which indicates that the retina is ischemic. Moreover, elevated DR may induce angiogenesis in DR patients. Early intervention provides a new way of thinking