海南医科大学学报

目的:探讨糖尿病视网膜病变(DR)患者血清中胞外5'-核苷酸酶(CD73)、apelin水平及临床意义。方法:收集2013年4月~2016年2月间本院收治的2型糖尿病患者108例,根据眼底荧光造影检查结果分为糖尿病无视网膜病变(NDR)组51例、背景期网膜病变(BDR)组40例、增殖期视网膜病变(PDR)组17例。入院后即刻,采用酶联免疫吸附法(ELISA)测定CD73、apelin水平;采用硫代巴比妥酸法及黄嘌呤氧化酶法测定血清氧化应激指标含量;采用ELISA法测定血管新生指标及炎症因子含量;采用Pearson检验分析DR患者血清CD73、apelin水平与病情相关指标含量的相关关系。结果:BDR组、PDR组血清CD73、apelin水平显著高于NDR组,PDR组血清CD73、apelin水平显著高于BDR组;BDR组、PDR组血清丙二醛(MDA)、晚期氧化蛋白产物(AOPP)、白介素-2(IL-2)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、血管内皮生长因子(VEGF)、血管生成素-2(Ang-2)、缺氧诱导因子1α(HIF-1α)含量高于NDR组,总抗氧化能力(TAOC)、超氧化物歧化酶(SOD)、白介素-10(IL-10)含量低于NDR组,PDR组以上指标变化趋势更显著;Pearson检验显示,DR血清CD73、apelin水平与病情相关指标含量存在直接相关关系。结论:DR患者存在异常高表达的CD73、apelin,且其表达量与病情严重程度存在直接内在联系,可作为DR早期诊断、预后判断的可靠指标。

Objective:To study the serum ecto-5'-nucleotidase(CD73)and apelin levels in patients with diabetic retinopathy(DR)and the clinical significance.Methods:A total of 108 patients with type 2diabetes treated in our hospital between April 2013 and February 2016 were collected and divided into non-diabetic retinopathy(NDR)group(n=51),background diabetic retinopathy(BDR)group(n=40)and proliferative diabetic retinopathy(PDR)group(n=17)based on the results offundus fluorescence angiography.Enzyme-linked immunosorbent assay(ELISA)was used to determine CD73 and apelin level immediately after admission;thiobarbituric acid method and xanthine oxidase method were used to determine the serum levels of oxidative stress indicators;ELISA method was used to determine the levels of angiogenesis indexes and inflammatory factors;Pearson test was used to analyze the correlation of serum CD73 and apelin levels with the illness-related indexes in patients with DR.Results:Serum CD73 and apelin levels of BDR group and PDR group were significantly higher than those of NDR group,and serum CD73 and apelin levels of PDR group were significantly higher than those of BDR group;serum malondialdehyde(MDA),advanced oxidation protein products(AOPP),interleukin-2(IL-2),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP),vascular endothelial growth factor(VEGF),angiogenin-2(Ang-2)and hypoxia-inducible factor 1α(HIF-1α)levels of BDR group and PDR group were significantly higher than those of NDR group while total antioxidant capacity(TAOC),superoxide dismutase(SOD)and interleukin-10(IL-10)levels were lower than those of NDR group,and the changes in above indexes of PDR group were more significant;Pearson test showed that serum CD73 and apelin levels in patients with DR were directly correlated with the levels of illness-related indexes.Conclusions:CD73and apelin expression are abnormally high in patients with DR,and their expression is directly correlated with the disease severity,and can be used as the reliable indicators for early diagnosis and prognosis judgment of DR.