同型半胱氨酸与糖尿病微血管病变的相关性及药物干预后的变化

发布时间：2018-05-14 11:23

本文选题：糖尿病 + 微血管病变　；参考：《南方医科大学学报》2016年11期

【摘要】：目的探讨同型半胱氨酸与糖尿病微血管病变的相关性及药物干预后的变化。方法 2型糖尿病患者200例,根据患者微血管并发症情况分为无微血管病变组和合并微血管病变组,所有患者治疗前及治疗6个月后进行血脂、血糖、肾功能及血清同型半胱氨酸测定。另外按年龄和性别匹配的原则选择同期进行体检的健康受试者100例作为正常对照组。结果(1)无血管病变组和合并微血管病变组患者常规测量收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、血脂测定包括总胆固醇(TC)、低密度脂蛋白(LDL)、血糖测定包括空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(Hb A1)、肾功能测定包括血清尿素氮(SUN)、血清肌酐(Scr)和血浆同型半胱氨酸(HCY)水平均显著高于正常对照组(P0.01),HDL水平显著低于正常对照组(P0.01);(2)合并微血管病变组患者的SBP、DBP、SUN、SCr和HCY水平显著高于无血管病变组(P0.01);(3)多因素logistic回归分析显示舒张压、尿素氮、血清肌酐和同型半胱氨酸水平是糖尿病患者发生微血管并发症的危险因素;(4)治疗后无微血管病变组和合并微血管病变组组患者HCY水平均较治疗前显著降低(P0.01)。结论高同型半胱氨酸水平是糖尿病微血管病变的高危因素,经治疗后可降低患者同型半胱氨酸水平。
[Abstract]:Objective to investigate the relationship between homocysteine and diabetic microangiopathy and the changes after drug intervention. Methods 200 patients with type 2 diabetes were divided into two groups according to their microvascular complications: no microangiopathy group and complicated microvascular disease group. All the patients were treated with blood lipids and blood glucose before and after treatment for 6 months. Renal function and serum homocysteine were measured. In addition, 100 healthy subjects who underwent physical examination at the same time were selected as normal control group according to the principle of age and sex matching. Results 1) systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TGG), total cholesterol (TC), low density lipoprotein (LDL), fasting blood glucose (FBG) and FBGG (fasting blood glucose) were measured in patients without vascular disease and in patients with microvascular disease. The levels of PBGN, HbA1C, serum urea nitrogen, creatinine (Scrs) and plasma homocysteine (HCY) were significantly higher than those of the normal control group (P 0.01), and the level of HDL was significantly lower than that of the normal control group (P 0.01C 2). The level of microblood was significantly higher than that of the normal control group (P 0.01C) and the level of plasma homocysteine (HCY) was significantly higher than that of the normal control group (P 0.01). The levels of SUNS SCR and HCY in the tubular lesion group were significantly higher than those in the non-vascular lesion group (P 0.01). The multivariate logistic regression analysis showed that diastolic blood pressure (DBP) was significantly higher than that in the non-vascular lesion group (P < 0.05). Urea nitrogen, serum creatinine and homocysteine levels were the risk factors of microvascular complications in diabetic patients. After treatment, the HCY levels in patients without microangiopathy and those with microangiopathy were significantly lower than those before treatment. Conclusion the high level of homocysteine is a high risk factor for diabetic microangiopathy, and it can reduce the level of homocysteine after treatment.
【作者单位】：中国海洋石油南海西部医院内科;
【基金】：湛江市科技计划项目(2015B01146)
【分类号】：R587.2

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