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目的 探讨血管紧张素转换酶 (ACE)基因多态性、血清ACE水平与 2型糖尿病并发视网膜病变 (DR)的关系。 方法 应用PCR方法检测 136例 2型糖尿病患者和 6 4名健康者ACE基因的缺失 /插入多态性和血清ACE水平 ,并用Logistic多元逐步回归 ,筛选出 2型糖尿病视网膜病变的高危因素。 结果 (1)ACE基因型频率和等位基因频率在糖尿病总组与正常对照组间差异无显著意义 (χ2 =3.3487,P >0 .0 5和 χ2 =3.72 5 7,P >0 .0 5 ) ,且在增殖期DR组和背景性DR组间差异亦无显著意义 (χ2 =3.335 9,P >0 .0 5和 χ2 =1.4 2 12 ,P >0 .0 5 )。 (2 )糖尿病并发DR组的DD基因型及D等位基因频率与无DR组相比差异有显著意义 (χ2 =10 .8783,P >0 .0 5和 χ2 =9.16 55 ,P >0 .0 5 ) ,且血清ACE水平在DR患者中明显升高 (t=12 .72 2 ,P <0 .0 5 ) ,与ACE基因多态性呈一致表现。 (3)Logistic多元逐步回归分析显示 ,ACE基因DD型、血清ACE水平、血胆固醇、空腹血糖和糖尿病病程是糖尿病视网膜病变发病的独立危险因素。 结论 糖尿病患者中DD基因型具有患DR易感性 ,并且在DR患者中ACE基因多态性与血清ACE水平呈一致表现
Objective To investigate the relationship between angiotensin converting enzyme (ACE) gene polymorphism and serum ACE levels and type 2 diabetic retinopathy (DR). Methods PCR was used to detect the deletion / insertion polymorphism of ACE gene and serum ACE in 136 type 2 diabetic patients and 64 healthy individuals. Logistic regression was used to screen out the risk factors of type 2 diabetic retinopathy. Results (1) ACE genotype frequency and allele frequency had no significant difference between the total diabetes group and the normal control group (χ2 = 3.3487, P> 0.05 and χ2 = 3.72 5 7, P> 0.05 ), And there was no significant difference between proliferative DR group and background DR group (χ2 = 3.335 9, P> 0.05 and χ2 = 1.4 2 12, P> 0.05). (2) There was significant difference in DD genotypes and D allele frequency between DR group and DR group (χ2 = 10.8783, P> 0.05 and χ2 = 9.16 55, P> 0). Serum ACE levels were significantly increased in patients with DR (t = 12.72 2, P <0.05), consistent with ACE gene polymorphism. (3) Logistic multiple stepwise regression analysis showed that ACE gene DD type, serum ACE level, blood cholesterol, fasting blood glucose and diabetes course were the independent risk factors of diabetic retinopathy. Conclusion The DD genotype in diabetic patients is predisposed to DR, and ACE gene polymorphism is consistent with that of serum ACE in DR patients