标题：血清胱抑素C与2型糖尿病视网膜病变及周围血管病变的相关性分析

      作者：吴冬波，梁江燕，薛平燕，廖 明
    (南方医科大学附属柳州医院柳州市柳铁中心医院内分泌科，广西 柳州 545007)

      卷次： 2015年26卷9期

      【摘要】 目的 探讨血清胱抑素C与2型糖尿病视网膜病变(DR)及周围血管病变(PAD)的关系。方法 选
取2012年1月至2014年1月我院内分泌科收治的2型糖尿病患者180例，行眼底检查、行下肢动脉彩色多普勒超
声检查以及触诊足背动脉、测定踝肱指数(ABI)。根据上述检查结果将研究者分为四组：2型糖尿病无并发症组
(A组，57例)，2型糖尿病伴视网膜病变组(B组，43例)，2型糖尿病伴周围血管病变组(C组，41例)以及2型糖尿病
伴视网膜病变和周围血管病变组(D组，39例)，测定并比较四组血清胱抑素C水平，采用Logistic多元回归分析患
者年龄、病程、血清胱抑素C以及各生化指标与2型糖尿病并发视网膜病变或（和）周围血管病变之间的相关性。
结果 B组、C组以及D组患者血清胱抑素C水平均明显高于A组，差异均有统计学意义(P均<0.01)。而且D组
患者血清胱抑素C水平明显高B组和C组，差异均有统计学意义(P均<0.01)。Logistic多元回归分析结果显示，血
清胱抑素C水平以及病程长短是２型糖尿病伴视网膜病变和周围血管病变的独立危险因素（P<0.05）。结论 血
清高胱抑素C水平为糖尿病视网膜病变和外周血管病变的独立危险因素，检测血清胱抑素C对评估糖尿病慢性
并发症的发生、发展有重要的临床意义。

      【关键词】 胱抑素C；2型糖尿病；视网膜病变；周围血管病变

      【中图分类号】 R587.2 【文献标识码】 A 【文章编号】 1003—6350（2015）09—1268—03


Correlation between cystatin C and diabetic retinopathy and peripheral artery disease in patients with type 2
diabetes mellitus.
WU Dong-bo, LIANG Jiang-yan, XUE Ping-yan, LIAO Ming. Department of Endocrinology,
Affiliated Liuzhou Hospital of Southern Medical University, Liuzhou Municipal Liutie Central Hospital, Liuzhou 545007,
Guangxi, CHINA

【Abstract】 Objective To investigate the correlation between serum cystatin C and diabetic retinopathy (DR)
and peripheral artery disease (PAD) in patients with type 2 diabetes mellitus (T2DM). Methods We performed the
analysis by collecting data from 180 patients with T2DM in our hospital between 2012 January and 2014 January. The
data of fundus examination, color Doppler ultrasonography for lower limb artery, palpation of dorsal artery, ankle bra-
chial index (ABI) were collected or calculated. Based on the above results, the patients were divided into four groups:
type 2 diabetes mellitus without complications (group A, 57 cases), type 2 diabetes mellitus with retinopathy (group B,
43cases), type 2 diabetes mellitus with peripheral artery disease (group C, 41 cases) and type 2 diabetes mellitus with
retinopathy and peripheral artery disease (group D, 39 patients). The serum level of cystatin C was compared among
the four groups. We performed multiple logistic regression analysis to define independent risks for diabetic retinopathy
and peripheral artery disease. Results There were significantly higher serum cystatin C levels in group B, C and D
compared to group A (All P<0.01). The serum cystatin C level was also higher in group D than in group B and
group C (All P<0.01). Multivariate logistic regression analysis showed that high serum cystatin C level and duration
for diabetes mellitus were independent risk factors for diabeticretinopathy and peripheral artery disease (P<0.05).
Conclusion The high level of serum cystatin C is the risk factor for diabetic retinopathy and peripheral artery dis-
ease, and it is very important to monitor the concentration of serum cystatin C in order to evaluate the occurrence and
development of the chronic complications in patients with type 2 diabetes mellitus.

      【Key words】 Cystatin C; Type 2 diabetes mellitus; Retinopathy; Peripheral vascular disease