目的：探讨和肽素(copeptin)和中期因子(midkine，MK)在糖尿病视网膜病变患者中的表达水平及其临床意义。

方法：选择2016-06/2017-10我院收治的180例2型糖尿病(T2DM)患者，根据糖尿病视网膜病变分期标准，将患者分为三组，其中无视网膜病变组68例，非增殖性视网膜病变组72例，增殖性视网膜病变组40例，另选同期体检健康者90例作为对照组，采用双抗体免疫夹心法检测copeptin水平，采用ELISA法检测MK水平，采用TOSOH全自动糖化血红蛋白分析仪检测糖化血红蛋白(HbA1c)，采用血常规仪器检测全血超敏C反应蛋白(hs-CRP)，采用全自动生化分析仪检测空腹血糖(FPG)、三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)水平，并记录各组收缩压(SBP)和舒张压(DBP)，并分析copeptin 和MK水平与血脂、血压、生化相关指标及糖尿病病程的关系。

结果：糖尿病视网膜病变患者copeptin 和MK水平明显高于对照组，且随着疾病进展，copeptin 和MK水平逐渐升高(P<0.05)。copeptin和MK水平均与HbA1c、hs-CRP、糖尿病病程呈正相关性(均P<0.05)，但与血脂、血压、FPG水平均无明显相关性(均P>0.05)。

结论：copeptin和MK水平与糖尿病视网膜病变的病程和病情严重程度密切相关，二者可能参与了糖尿病视网膜病变的发生发展。

METHODS: Totally 180 patients with type 2 diabetes mellitus(T2DM)admitted to our hospital from June 2016 to October 2017 were divided into three groups according to the criteria of diabetic retinopathy staging. Among them, there were no retinopathy group(68 cases), non-proliferative retinopathy group(72 cases), proliferative retinopathy group(40 cases)and 90 healthy subjects in the same period as the control group. The copeptin level was detected by double antibody immunosorbent assay and the MK level by ELISA. The glycosylated hemoglobin(HbA1c)was detected by TOSOH automatic glycosylated hemoglobin analyzer and the whole blood hs-CRP was detected by using blood routine instrument. Fasting plasma glucose(FPG), triglyceride(TG), cholesterol(TC), low density lipoprotein(LDL-C)and high density lipoprotein(HDL-C)were detected by automatic biochemical analyzer and the systolic blood pressure(SBP)and diastolic blood pressure(DBP)of each group were recorded. The relationship between copeptin and MK levels and blood lipid, blood pressure, biochemical parameters and the course of diabetes mellitus were also analyzed.

RESULTS: The levels of copeptin and MK in patients with diabetic retinopathy were significantly higher than those in controls, and the levels of copeptin and MK were gradually increased with the progress of disease(P<0.05). The levels of copeptin and MK were correlated with the levels of HbA1c, hs-CRP and course of T2DM(P<0.05), but no significant correlation with plasma lipids, blood pressure and FPG(all P>0.05).

CONCLUSION: The copeptin and MK levels are closely related to the course of diabetic retinopathy and the severity of the disease, both of which may be involved in the development of diabetic retinopathy.