标题：糖尿病视网膜病变神经细胞凋亡及醛糖还原酶和晚期糖化终产物受体对其影响的机制

      作者：王静 1，宋向欣 1，哈尼克孜·阿布都艾尼 1，韩莉 1，杨波 2，刘琪 2，王新玲 1    (新疆维吾尔自治区人民医院内分泌科 1、眼科 2，新疆 乌鲁木齐 830001)

      卷次： 2018年29卷17期

      【摘要】 目的 分析糖尿病(DM)视网膜病变患者神经细胞凋亡及醛糖还原酶和晚期糖化终产物受体对其影响的机制。方法 选取新疆维吾尔自治区人民医院 2017年 1月至 2018年 3月收治的 350例糖尿病患者作为DM组，其中，视网膜病变(DR)患者 150例，无视网膜病变(NDR)患者 200例，而DR组中又分为单纯型视网膜病变组(SDR组，127例)和增殖型视网膜病变组(PDR组，23例)，以同期 150例健康体检者为对照组。观察各组晚期糖基化终产物受体基因-374T/A及-429T/C多态性等位基因及基因型分布、临床基本特征以及神经细胞凋亡率的差异。结果 DM组患者的-374T/A、-429T/C多态性等位基因及基因型分布与对照组比较，差异均无统计学意义(P>0.05)；DM组患者的性别比例、吸烟者比例及体质量指数(BMI)与对照组比较差异亦无统计学意义(P>0.05)；但DM组患者的糖尿病家族史比例、年龄、血压、血糖及血脂等指标明显高于对照组，差异均有统计学意义(P<0.05)；PDR组、SDR组和NDR组患者的-374T/A多态性等位基因比较差异有统计学意义(P<0.05)；而-374T/A多态性基因型分布、-429T/C多态性等位基因及基因型分布比较则差异均无统计学意义(P>0.05)；DR组患者的性别、年龄、吸烟者比例、舒张压、血糖、空腹胰岛素、空腹血清C肽及血脂指标与NDR组比较，差异均无统计学意义(P>0.05)，而病程、BMI、收缩压、餐后2 h胰岛素、餐后2 h血清C肽等指标与NDR组比较，差异均有统计学意义(P<0.05)；DM组患者的早期凋亡率为(13.1±3.1)%，中晚期凋亡率为(10.1±2.1)%，明显高于对照组的(2.3±0.9)%和(1.2±1.0)%，差异均有统计学意义(P<0.05)。结论 糖尿病视网膜病变神经细胞凋亡与晚期糖化终产物受体基因-374T/A多态性等位基因及基因型分布、血糖、血脂及血压等指标密切相关，在临床中值得研究。
      【关键词】 糖尿病；视网膜病变；神经细胞凋亡；醛糖还原酶；晚期糖化终产物受体
      【中图分类号】 R587.2 【文献标识码】 A 【文章编号】 1003—6350（2018）17—2387—04

Study on neuronal apoptosis and the mechanism of effects of aldose reductase and advanced glycation endproducts receptors on it in patients with diabetic retinopathy.
WANG Jing 1, SONG Xiang-xin 1, Hankiz AbramovichAini 1, HAN Li 1, YANG Bo 2, LIU Qi 2, WANG Xin-ling 1. Department of Endocrinology 1, Department of Ophthalmology 2, thePeople's Hospital of Xinjiang Uygur Autonomous Region, Urumchi 830001, Xinjiang, CHINA
【Abstract】 Objective To analyze neuronal apoptosis and the mechanism of effects of aldose reductase and ad-vanced glycation end products receptors on it in patients with diabetic (DM) retinopathy. Methods Three hundred andfifty patients with diabetes mellitus admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from Janu-ary 2017 to March 2018 were selected as DM group, including 150 patients with diabetic retinopathy (DR) group and200 patients without diabetic retinopathy (NDR) group; in the DR group, patients were subdivided into a simple retinopa-thy group (SDR group, 127 cases) and a proliferative retinopathy group (PDR group, 23 cases). A total of 150 healthysubjects in the same period were enrolled as control group. The alleles and genotype distribution of the receptor for ad-vanced glycation end-products (RAGE) gene -374T/A and -429T/C polymorphisms, basic clinical characteristics anddifferences in neuronal apoptosis rates in each group were observed. Results There were no statistically significant dif-ferences in the alleles and genotype distribution of -374T/A and -429T/C polymorphisms between the DM group andthe control group (P>0.05). The differences in gender ratio, smoker proportion and body mass index (BMI) between twogroups were not statistically significant (P>0.05). However, the proportion of family history of diabetes, age, blood pres-sure, blood sugar, and blood lipids in the DM group were significantly higher than those in the control group (P<0.05).There were significant differences in -374T/A polymorphism alleles between the PDR group, the SDR group and theNDR group (P<0.05); while the differences in -374T/A polymorphism genotype distribution, the-429T/C polymorphismalleles and genotype distribution between the three groups were not statistically significant (P>0.05). The gender, age,proportion of smokers, diastolic blood pressure, blood glucose, fasting insulin, fasting serum C-peptide, and blood lipidsin the DR group were not statistically significant different from those in the NDR group (P>0.05), but the differences in·论 著·doi:10.3969/j.issn.1003-6350.2018.17.006