血清及泪液ET-1 MDA MMP-9水平与2型糖尿病伴干眼症患者病情严重程度的相关性

doi:10.3969/j.issn.1006-6233.2025.11.018

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摘要 目的: 探究血清及泪液内皮素-1(ET-1)、丙二醛(MDA)、基质金属蛋白酶-9(MMP-9)与2型糖尿病(T2DM)伴干眼症(DED)患者病情严重程度的相关性。方法: 选取2023年9月至2024年9月中部战区总医院收治的136例T2DM患者,根据其是否伴有DED分为DED组54例,非DED组82例;另选择同期同年龄段通过健康体检的120例健康人为对照组。根据病情评估结果,将DED组患者分为轻度组24例,中/重度组30例。T2DM患者中/重度DED的风险因素则通过多因素Logistic回归分析;ROC分析血清及泪液ET-1、MDA、MMP-9水平对T2DM患者中/重度DED的诊断价值。结果: 与对照组相比,DED组、非DED组患者血清及泪液ET-1、MDA、MMP-9水平明显升高,DED组显著高于非DED组(P<0.05);相较于轻度组,中/重度组患者血清及泪液ET-1、MDA、MMP-9表达显著上调(P<0.05);血清及泪液ET-1、MDA、MMP-9水平升高是T2DM患者发生中/重度DED的独立危险因素(P<0.05);血清ET-1、MDA、MMP-9水平联合诊断T2DM患者中/重度DED的AUC为0.981,联合诊断AUC优于单独诊断(Z=2.231,2.325,2.508,P<0.05);泪液ET-1、MDA、MMP-9水平联合诊断T2DM患者中/重度DED的AUC为0.983,联合诊断AUC优于单独诊断(Z=2.105,2.457,2.751,P<0.05)。结论: T2DM伴DED患者血清及泪液ET-1、MDA、MMP-9表达上调,与患者DED病情有关,三者联合诊断T2DM患者中/重度DED具有一定价值。

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关键词 ： 2型糖尿病, 干眼症, 内皮素-1, 丙二醛, 基质金属蛋白酶-9

Abstract：Objective: To explore the correlation between serum and tear endothelin-1 (ET-1), malondialdehyde (MDA), matrix metalloproteinase-9 (MMP-9) and the severity of type 2 diabetes mellitus (T2DM) with dry eye disease (DED). Methods: Totally 136 patients with T2DM admitted to the general hospital of central theater command from September 2023 to September 2024 were selected and divided into DED group (54 cases) and non-DED group (82 cases) according to whether they were accompanied by DED. Another 120 healthy individuals of the same age range who passed the health examination were made the control group. Complying with the evaluation results of the disease, the DED group was assigned into the mild group of 24 cases and the moderate/severe group of 30 cases. The risk factors for moderate/severe DED in T2DM patients were analyzed using multiple logistic regression. ROC was used to analyze the diagnostic value of serum and tear ET-1, MDA, and MMP-9 for moderate/severe DED in T2DM. Results: The DED group and non-DED group had prominently higher serum and tear ET-1, MDA, and MMP-9 than control group, meantime, the DED group had prominently higher results than the non-DED group (P<0.05). The moderate/severe group showed obvious upregulation of serum and tear ET-1, MDA, and MMP-9 expression than mild group (P<0.05). Elevated levels of ET-1, MDA, and MMP-9 in serum and tears were independent risk factors for moderate/severe DED in T2DM (P<0.05). The AUC of joint of serum ET-1, MDA, and MMP-9 in the diagnosis of moderate/severe DED in T2DM was 0.981, and the AUC of joint diagnosis was better than that of single diagnosis (Z=2.231, 2.325, 2.508, P<0.05). The AUC of joint diagnosis of ET-1, MDA, and MMP-9 in tears for moderate/severe DED in T2DM was 0.983, and the AUC of joint diagnosis was better than that of single diagnosis (Z=2.105, 2.457, 2.751, P<0.05). Conclusion: The ET-1, MDA, and MMP-9 in the serum and tears of T2DM patients with DED are upregulated, and they are related to condition of DED. The joint diagnosis for moderate/severe DED in T2DM by the three methods has certain value.

Key words： Type 2 diabetes mellitus Dry eye disease Endothelin-1 Malondialdehyde Matrix metalloproteinase-9

基金资助:湖北省卫生健康委员会科研项目,(编号:WJ2021M224)

通讯作者: 丁琴

引用本文:

马晓玉, 张璐, 陆思林, 杜霖, 丁琴. 血清及泪液ET-1 MDA MMP-9水平与2型糖尿病伴干眼症患者病情严重程度的相关性[J]. 河北医学, 2025, 31(11): 1868-1873.
MA Xiaoyu, ZHANG Lu, LU Silin, et al. Correlation between ET-1 MDA MMP-9 in Serum and Tears and Severity of Type 2 Diabetes Mellitus with Dry Eye Disease. HeBei Med, 2025, 31(11): 1868-1873.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.11.018 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I11/1868

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