方法：选择2型糖尿病患者85例，其中非增殖期糖尿病视网膜病变(non-proliferative DR，NPDR)患者23例、增殖期糖尿病视网膜病变(proliferative DR，PDR)患者30例及无视网膜病变(non-diabetic retinopathy，NDR)患者32例。选择同期健康体检者为对照组(80例)。收集血清样本，采用酶联免疫吸附法(ELISA)双抗体夹心法检测循环血中Dickkopf-3的相对表达水平，并比较各组血浆Dickkopf-3的水平。

结果：糖尿病视网膜病变患者血浆Dickkopf-3平均含量为430.16±198.11pg/mL，明显低于健康对照组(627.48±294.45pg/mL)及无视网膜病变患者(601.99±194.16pg/mL)，差异有统计学意义(P<0.05)； 而无视网膜病变与健康对照组Dickkopf-3水平比较，差异无统计学意义(P=0.729)； 增殖期糖尿病视网膜病变患者Dickkopf-3的水平(396.38±185.59pg/mL)低于非增殖期糖尿病视网膜病变患者(538.82±187.20pg/mL)，差异有统计学意义(P=0.002)。

结论：Dickkopf-3蛋白水平降低可能与糖尿病视网膜病变的发生发展有关，与增殖期糖尿病视网膜病变有显著相关性。循环血中Dickkopf-3蛋白对糖尿病视网膜病变具备一定的鉴别效能，有可能成为糖尿病视网膜病变患者外周血的检测指标。

METHODS:Eighty-five type 2 diabetic patients, included the non-proliferative diabetic retinopathy(NPDR)23 patients, proliferative diabetic retinopathy, proliferative DR(PDR)in patients with 30 and non-diabetic retinopathy(NDR)with 32 cases. The same period of healthy physical examination was selected as control group(80 cases). Serum samples were collected, and the relative expression level of Dkk-3 was detected by enzyme-linked immunosorbent assay(ELISA)double antibody sandwich assay. The statistical differences were compared between groups.

RESULTS:The plasma level of Dkk-3(430.16±198.11pg/mL)in DR patients was significantly lower than that in healthy control group(627.48±294.45 pg/mL; P<0.05)and NDR patients(601.99±194.16 pg/mL; P<0.05). While there was no significant difference in Dkk-3 level between NDR and healthy control group(P=0.729). The level of PDR in patients with Dkk-3(396.38±185.59 pg/mL)was lower than that of NPDR(538.82±187.20 pg/mL; P=0.002).

CONCLUSION:The decrease of Dkk-3 level may be related to the occurrence and development of diabetic retinopathy, and there is a significant correlation with PDR. Circulating blood Dkk-3 protein in diabetic retinopathy has a certain differential efficacy, it is likely to become diabetic retinopathy patients peripheral blood test indicators.