目的：探讨基质金属蛋白酶-9(MMP-9)、糖化白蛋白(GA)、糖化血红蛋白(HbA1c)和脂肪因子(包括内脂素、抵抗素和瘦素)与糖尿病视网膜病变(DR)的相关性。

方法：选取2015-03/2017-03在我院治疗的DR患者74例148眼，其中非增生性糖尿病视网膜病变患者(NPDR)40例80眼，增生性糖尿病视网膜病变患者(PDR)34例68眼，同时选取非DR单纯糖尿病患者(NDR)40例80眼以及健康志愿者40例80眼作为对照，检测各组MMP-9、GA、HbA1c、内脂素、抵抗素和瘦素水平。

结果：PDR组内脂素为4.41±0.82ng/mL，明显低于NPDR组、NDR和对照组(P<0.05)，而抵抗素、瘦素和MMP-9分别为9.01±1.04ng/mL、17.96±2.03μg/L和740.06±84.43μg/L，GA和HbA1c分别为26.14%±4.57%、17.60%±1.91%，明显高于NPDR组、NDR组和对照组(P<0.05)； NPDR组内脂素为6.44±0.79ng/mL，明显低于NDR和对照组(P<0.05)，而抵抗素、瘦素和MMP-9分别为7.80±0.87ng/mL、15.68±1.98μg/L、634.12±80.22μg/L，GA和HbA1c分别为22.06%±4.38%、12.46%±1.69%，明显高于NDR组和对照组(P<0.05)； MMP-9、GA、HbA1c与DR水平呈正相关(r_s=0.523、0.461、0.414，P<0.05)； 内脂素与DR呈负相关(r_s=-0.433，P<0.05)，抵抗素和瘦素与DR水平呈正相关(r_s=0.401、0.460，P<0.05)。

结论：MMP-9、GA、HbA1c和脂肪因子可能在DR发生发展中有一定作用，其中MMP-9和脂肪因子有相关性，两者与GA、HbA1c水平无明显关系。

METHODS: From March 2015 to March 2017, 74 patients with DR were treated in our hospital, including 40 patients(80 eyes)with non proliferative diabetic retinopathy(NPDR)and 34 patients(68 eyes)with proliferative diabetic retinopathy(PDR), and diabetes mellitus 40 patients(80 eyes)with non DR(NDR)and 40 healthy volunteers(80 eyes)were selected as controls, the levels of MMP-9, GA, HbA1c, visfatin, resistin and leptin in each group were detected.

RESULTS: PDR group visfatin was 4.41±0.82ng/mL, was significantly lower than the NPDR group, NDR group and control group(P<0.05), while, resistin, leptin and MMP-9 were 9.01±1.04ng/mL, 17.96±2.03μg/L and 740.06±84.43μg/L, GA and HbA1c were 26.14%±4.57% and 17.60%±1.91%, significantly higher than those of NPDR group, NDR group and control group(P<0.05). NPDR group visfatin was 6.44±0.79ng/mL, was significantly lower than that of NDR group and control group(P<0.05), while, resistin, leptin and MMP-9 were 7.80±0.87ng/ml, 15.68±1.98μg/L and 634.12±80.22μg/L, GA and HbA1c were 22.06%±4.38% and 12.46%±1.69%, significantly higher than those of NDR group and control group(P<0.05). MMP-9, GA, HbA1c were positively with DR levels(r_s=0.523, 0.461 and 0.414, P<0.05); visfatin was negatively correlated with DR levels(r_s=-0.433, P<0.05), resistin and leptin were positively correlated with DR levels(r_s=0.401 and 0.460, P<0.05).

CONCLUSION: MMP-9, GA, HbA1c, and adipokines may play a role in the development and progression of DR, in which MMP-9 is associated with adipokines, both are not significantly related to the levels of GA and HbA1c.