方法： 选取2017-10 /2019-01年于保定市第一中心医院内分泌科住院的2型糖尿病患者167例作为研究对象，分为单纯2型糖尿病组(DM组)59例和2型糖尿病合并视网膜病变组(DR组)108例，DR组包括2型糖尿病视网膜病变非增殖期组(NPDR组)45例、2型糖尿病视网膜病变增殖期组(PDR组)63例。另选取57例健康体检者作为对照组(NC组)。测量四组研究对象身高、体质量并计算体质量指数(BMI)，BMI=体质量/身高²(kg/m²)。测定空腹静脉血糖(FPG)、收缩压(SBP)、舒张压(DBP)、胆固醇(TC)、甘油三酯(TG)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血尿素氮(BUN)、血肌酐(SCR)、血红蛋白(HbA1c)，应用酶联免疫吸附法测定血清Adropin蛋白(AD)和脑啡肽酶(NEP)水平，AD、NEP与其他指标的相关性采用Pearson相关分析。两者各自独立的影响因素采用多元线性回归法分析。

结果：与NC组相比，DM组、NPDR组、PDR组的AD水平逐渐降低，以PDR组最低(P<0.05)。各组NEP水平逐渐升高，以PDR组最高(P<0.05)。多元线性回归分析提示FPG、HbA1c、NEP为AD的独立危险因素，BMI、FPG、HbA1c、AD是NEP的独立影响因素。

结论：在2型糖尿病视网膜病变患者中，AD水平随着DR的进展而降低，NEP水平则随着DR的进展而升高，表明血清AD和NEP有可能参与了DR的发生和发展。

METHODS: A total of 167 patients with type 2 diabetes were enrolled in this study. They were divided into simple type 2 diabetes group(DM group)with 59 cases and type 2 diabetic retinopathy group(DR group)with 108 cases. Furthermore, the DR group included patients in two periods of non-proliferation diabetic retinopathy(NPDR group)and proliferative diabetic retinopathy(PDR group). There were 45 patients in NPDR group and 63 patients in PDR group, meanwhile, another 57 healthy subjects were selected as the normal control group(NC group). Measuring the hight and weight and calculating body mass index(BMI). Indices of fasting plasma glucose(FPG), systolic blood pressure(SBP), diastolic blood pressure(DBP), total cholesterol(TC), triacylglycerol(TG), alanine aminotransferase(ALT), aspartate aminotransferase(AST)hemoglobin Alc(HbA1c)were be detected, while levels of serum adropin protein(AD)and neprilysin(NEP)were measured by enzyme-linked immunosorbent assay(ELISA). The correlation between AD, NEP and other indicators was analyzed by Pearson correlation analysis. The independent influence factors of both were analyzed by multiple linear regression.

RESULTS: Compared with the NC group, the AD level in the DM group, NPDR group, and PDR group decreased gradually, with the lowest level in the PDR group(P<0.05). The level of NEP in each group gradually increased, and the highest one was in the PDR group(P<0.05). Multiple linear regression analysis indicated that FPG, HbA1c and NEP were independently correlated with AD. BMI, FPG, HbA1c and AD were independently correlated with NEP.

CONCLUSION: In patients with diabetic retinopathy, AD level would be decreased with the progression of DR, and NEP level would be gradually increased, both of which may be involved in the development of DR.