目的检测糖尿病视网膜病变(DR)患者血清补体因子C3和C4的含量变化，探讨其在DR发生和发展中的作用。
方法采用病例对照研究设计，选取2017年12月至2018年12月在哈尔滨医科大学附属第一医院确诊的DR患者195例作为DR组，纳入2型糖尿病患者150例作为糖尿病组，同期收集281例单纯年龄相关性白内障或斜视患者作为对照组。采集受检者晨起空腹静脉血并分离血清。采用免疫散射比浊法测定血清中C3、C4的质量浓度。采用速率法测定谷丙转氨酶(ALT)、谷草转氨酶(AST)的含量；采用酶法测定总胆固醇、三酰甘油的含量。采用Pearson线性相关分析法评估各组血清补体因子C3和C4与各临床参数的相关性，采用逐步回归分析法评估补体因子C3和C4水平的影响因素。
结果糖尿病组血清中C3质量浓度为(1 154.0±177.4)mg/L，明显高于DR组的(1 077.3±177.0)mg/L和对照组的(1 072.0±184.3)mg/L，差异均有统计学意义(均 P<0.05)；DR组血清补体因子C4质量浓度为(287.5±83.5)mg/L，明显高于糖尿病组的(257.5±70.1)mg/L和对照组的(263.7±77.2)mg/L，差异均有统计学意义(均 P<0.05)。相关性分析结果显示，在糖尿病及DR组中补体因子C3的表达水平与总胆固醇及三酰甘油均呈弱正相关(糖尿病组： r＝0.250、0.205，均 P<0.05；DR组： r＝0.308、0.213，均 P<0.01)；在DR组中补体因子C4的表达水平与总胆固醇及三酰甘油均呈弱正相关( r＝0.235， P＝0.002； r＝0.247， P＝0.001)。多元回归分析表明总胆固醇及三酰甘油是DR组血清C3、C4表达的影响因素。
结论补体因子可能参与了DR的病理进程，DR患者血清补体因子C3和C4受血清总胆固醇和三酰甘油的影响。
ObjectiveTo detect the changes of serum complement factors C3 and C4 in diabetic retinopathy (DR) patients, and to explore their role in the occurrence and development of DR.
MethodsA cases-controlled study was carried out.Total of 195 patients with DR diagnosed in the First Affiliated Hospital of Harbin Medical University from December 2017 to December 2018 were selected as the DR group, 150 patients with type 2 diabetes were included as the diabetes group, and 281 simple age-related cataract or strabismus patients were collected at the same time and served as control group.Fasting venous blood was collected and serum was isolated.The concentration of C3 and C4 in serum was determined by immunoturbidimetry.The contents of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined by rate method, and the contents of total cholesterol and triglyceride were determined by enzyme method.Pearson linear correlation analysis was used to evaluate the correlation between serum complement factors and clinical parameters.Stepwise regression analysis was used to evaluate the influencing factors of complement factor C3 and C4 expression.This study adhered to the tenets of the Declaration of Helsinki and was approved by the Ethical Committee Review Board of the First Affiliated Hospital of Harbin Medical University(No.2016-81500711).
ResultsThe concentration of serum complement factor C3 in the diabetes group was (1 154.0±177.4)mg/L, which was significantly higher than (1 077.3±177.0)mg/L in the DR group and (1 072.0±184.3)mg/L in the control group, the differences were statistically significant (all at P<0.05); The concentration of serum complement factor C4 in the DR group was (287.5±83.5)mg/L, which was significantly higher than (257.5±70.1)mg/L in the diabetes group and (263.7±77.2)mg/L in the control group, the differences were statistically significant (all at P<0.05). The correlation analysis results showed that the expression level of complement factor C3 was weakly positively correlated with total cholesterol and triglyceride in the diabetes and DR groups (diabetes group: r=0.250, P<0.05; r=0.205, P<0.05.DR group: r=0.308, P<0.01; r=0.213, P<0.01); The expression level of complement factor C4 was weakly positively correlated with total cholesterol and triglyceride in the DR group ( r=0.235, P=0.002; r=0.247, P=0.001). Multiple regression analysis showed that total cholesterol and triglyceride were the influencing factors of serum C3 and C4 expression in the DR group.
ConclusionsComplement factors may participate in the pathological process of DR and serum complement factors C3 and C4 are affected by serum total cholesterol and triglyceride in DR patients.
孙洪岩,马瑞瑞,陈加玉,等. 糖尿病视网膜病变患者血清补体因子含量变化[J]. 中华实验眼科杂志,2020,38(09)：754-759.
DOI:10.3760/cma.j.cn115989-2019051-00212版权归中华医学会所有。
未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。
除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。
文档即答
智问智答
机器翻译
你好，我可以帮助您更好的了解本文，请向我提问您关注的问题。
