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目的了解2型糖尿病视网膜病变患者血脂谱的变化及其与糖尿病视网膜病变(DR)发生的关系。方法选取2型糖尿病患者224例,分为无视网膜病变(NDR)组110例,DR组114例。进行血脂和糖化血红蛋白等生化指标的检测,分析两组患者间病程、糖化血红蛋白及各项血脂指标与视网膜病变的相关性。结果在各项血脂指标中,DR组载脂蛋白B(ApoB)、脂蛋白(a)[Lp(a)]高于NDR组,而载脂蛋白A(ApoA)/ApoB低于NDR组,两组差异有统计学意义(P<0.05)。多因素非条件Logistic回归分析显示,DR的发生与Lp(a)水平(OR=1.30,95%CI:1.01～1.67),ApoA/ApoB(OR=0.54,95%CI:0.33～0.87)及病程(OR=1.73,95%CI=1.30～2.30)相关联。结论 Lp(a)及ApoA/ApoB等血脂异常可能是DR的危险因素之一,积极地纠正血脂紊乱有利于糖尿病视网膜病变的防治。
Objective To investigate the changes of serum lipid profile and the relationship with diabetic retinopathy (DR) in type 2 diabetic retinopathy. Methods 224 patients with type 2 diabetes mellitus were selected and divided into 110 cases without retinopathy (NDR) and 114 cases with DR. Blood lipid and glycosylated hemoglobin and other biochemical indicators of detection, analysis of disease duration between the two groups, glycosylated hemoglobin and various lipid indicators and the correlation between retinopathy. Results ApoB, Lp (a) in DR group were higher than those in NDR group and ApoA / ApoB group were lower than those in NDR group The difference was statistically significant (P <0.05). Multivariate non-conditional Logistic regression analysis showed that the incidence of DR was positively correlated with the level of Lp (a) (OR = 1.30, 95% CI: 1.01-1.67), ApoA / ApoB (OR = 0.54, 95% CI: 0.33-0.87) (OR = 1.73, 95% CI = 1.30-2.30). Conclusions Dyslipidemia such as Lp (a) and ApoA / ApoB may be one of the risk factors of DR. It is helpful to prevent and treat diabetic retinopathy by actively correcting dyslipidemia.