目的　探讨血清总同型半胱氨酸 (Hcy)水平与老年人 2型糖尿病视网膜病 (DR)的关系及与其他危险因素的关系。方法　用免疫化学发光法检测 54例老年 2型糖尿病患者和 2 0例非糖尿病对照者的血清 Hcy水平 ,并收集其他相关危险因素资料。结果　 (1 )单因素分析结果显示 :DR组 (2 4例 )糖尿病病程、血浆糖化血红蛋白 (Hb A1 C)、血清甘油三酯 (TG)和 Hcy水平明显高于 2型糖尿病无视网膜病组 (NDR) (30例 )和非糖尿病对照组 (P<0 .0 5) ;(2 )血清 Hcy水平与 Hb A1 C呈正相关 ,与空腹胰岛素 (FINS)水平呈负相关 (P<0 .0 5) ;(3)多元 Logistic回归分析表明 ,血清Hcy水平增高是老年 DR的独立变异危险因素。结论　血清 Hcy水平增高与老年 DR的发病有关。 Objective To investigate the relationship between serum total homocysteine ​​(Hcy) level and type 2 diabetic retinopathy (DR) in elderly patients and its relationship with other risk factors. Methods Serum Hcy levels were measured in 54 elderly patients with type 2 diabetes mellitus and 20 non-diabetic controls by immunochemical chemiluminescence. Other relevant risk factors were collected. Results (1) The results of univariate analysis showed that the duration of diabetes, Hb A1 C, triglyceride (TG) and Hcy in DR group were significantly higher than those in type 2 diabetic patients without retinopathy (N = 30) and non-diabetic control group (n = 0). (2) Serum Hcy level was positively correlated with Hb A1 C and negatively correlated with fasting insulin (FINS) ). (3) Multivariate logistic regression analysis showed that the increase of serum Hcy level was the risk factor of independent mutation in elderly DR. Conclusions The increase of serum Hcy level is related to the pathogenesis of senile DR.