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目的:分析miR-15和miR-29a在糖尿病视网膜病变(DR)患者血清中的表达水平及其对DR的诊断价值。方法:将2016年6月至2018年8月在本院就诊的155例(155眼)2型糖尿病(DM)患者，根据是否发生视网膜病变及病变程度分为：无视网膜病变组50例(NDR组)、单纯性视网膜病变组56例(SDR组)和增生性视网膜病变组49例(PDR组)，另选取同时期50例健康者为对照组。检测受试者甘油三酯(TG)、总胆固醇(TC)、空腹血糖(FPG)等临床指标，采用实时荧光定量PCR检测受试者血清miR-15和miR-29a表达水平，Pearson相关法分析DR患者血清miR-15和miR-29a表达水平与临床指标的关系，受试者工作特征曲线(ROC)评估miR-15和miR-29a对DR的诊断价值。结果:NDR组、SDR组、PDR组血清中miR-15相对表达量均低于对照组(n P<0.05)，且miR-15相对表达量在NDR组、SDR组、PDR组中呈逐渐降低趋势(n P<0.05)；NDR组、SDR组、PDR组血清中miR-29a相对表达量均高于对照组(n P<0.05)，miR-29a相对表达量在NDR组、SDR组、PDR组中呈逐渐升高趋势(n P<0.05)；DR患者血清miR-15表达水平与UACR、HbA1c和DM病程呈负相关(n r＝－0.732、－0.492、－0.589，n P<0.05)，miR-29a表达水平与UACR、HbA1c和DM病程呈正相关(n r＝0.744、0.508、0.556，n P<0.05)；miR-15、miR-29a诊断DR的ROC曲线下面积(AUC)为0.796(95%n CI：0.724～0.857)、0.677(95% n CI：0.597～0.749)，其诊断临界值为0.63、1.11，灵敏度为84.9%、53.8%，特异度为65.3%、79.6%；miR-29a是DR发生的危险因素，而miR-15是DR发生的保护因素。n 结论:DR患者血清中miR-15表达降低，miR-29a表达升高，与患者视网膜病变程度有关，可作为DR早期诊断的生物学标志物。“,”Objective:To analyze the expression levels of miR-15 and miR-29a in serum of patients with diabetic retinopathy (DR) and their diagnostic values for DR.Methods:155 patients (155 eyes) with type 2 diabetes mellitus (DM) were treated in our hospital from June 2016 to August 2018, according to the occurrence of retinopathy and the degree of retinopathy, the patients were divided into five groups: 50 cases of non-retinopathy group (NDR group), 56 cases of simple retinopathy group (SDR group), 49 cases of proliferative retinopathy group (PDR group) and another 50 healthy persons in the same period were selected as the control group. Triglyceride (TG), total cholesterol (TC), and fasting blood glucose (FPG) were measured. Levels of serum miR-15 and miR-29a were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Pearson correlation method was used to analyze the relationships between levels of serum miR-15 and miR-29a with clinical indicators in DR patients. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic values of miR-15 and miR-29a in DR.Results:The relative expression of miR-15 in serum of NDR group, SDR group, and PDR group were lower than that of control group (n P<0.05), and the relative expression of miR-15 in NDR group, SDR group, and PDR group decreased gradually (n P<0.05); the relative expression of miR-29a in serum of NDR group, SDR group, and PDR group were higher than that of control group (n P<0.05), and the mRNA relative expression of miR-29a in NDR group, SDR group, and PDR group increased gradually (n P<0.05); the expression of serum miR-15 in DR patients was negatively correlated with urinary albumin/creatinine (UACR), glycosylated hemoglobin (HbA1c) and the course of DM (n r=-0.732, -0.492, -0.589, n P<0.05); the expression level of miR-29a was positively correlated with UACR, HbA1c and the course of DM (n r=0.744, 0.508, 0.556, n P<0.05); the areas under the ROC curve (AUC) of miR-15 and miR-29a for DR diagnosis were 0.796 (95%n CI: 0.724-0.857) and 0.677 (95% n CI: 0.597-0.749), with diagnostic thresholds 0.63 and 1.11, sensitivities 84.9% and 53.8%, specificities 65.3% and 79.6%, repectively; miR-29a was a risk factor for DR, while miR-15 was a protective factor for DR.n Conclusions:The expression of mir-15 and miR-29a in the serum of DR patients is decreased, which is related to the degree of retinopathy and can be used as biomarkers for early diagnosis of DR.