血同型半胱氨酸对糖尿病肾病和2型糖尿病合并颈动脉斑块的影响的临床研究

金亚丽，袁永红，全菊花，王家媚，吴俊峰，杨芳华，秦小龙，陈小梅陇西县第一人民医院内分泌科，甘肃陇西　748100

血同型半胱氨酸对糖尿病肾病和2型糖尿病合并颈动脉斑块的影响的临床研究

金亚丽，袁永红，全菊花，王家媚，吴俊峰，杨芳华，秦小龙，陈小梅
陇西县第一人民医院内分泌科，甘肃陇西748100

目的探讨高同型半胱氨酸对2型糖尿病及糖尿病大血管及微血管的影响，脂在探求2型糖尿病的治疗与预防。方法选取201例根据糖尿病诊疗指南确诊为2型糖尿病的患者与65例排除糖尿病的健体检者作为对照，分别检测其血清同型半胱氨酸浓度、甘油三酯、总胆固醇、低密度胆固醇，糖尿病患者同时检测糖化血红蛋白，眼底、肾功（化学发光法）、血糖并进行统计学分析，分析血同型半胱氨酸与糖尿病的发生、糖尿病微血管病变，糖尿病大血管病变关系。结果糖尿病组的血同型半胱氨酸高于对照组（14.74 7.11%vs9.86 3.8064%）（P＜0.05）：糖尿病肾病组血同型半胱氨酸水平高于对照组（17.08 8.95%vs9.86 3.80%）（P＜0.05）；2型糖尿病合并颈动脉斑块组血同型半胱氨酸水平高于对照组（21.39 8.82%vs9.86 3.80%），（P＜0.05）；Hcy与年龄、TC TG HDL-C LDL-C等因素无统计学差异。结论 高血同型半胱氨酸是2型糖尿病发生的危险因素，是糖尿病肾病的促发因素，Hcy在糖尿病患者动脉粥样硬化发生发展中起重要因素。

2型糖尿病；血同型半胱氨酸；颈动脉斑块；糖尿病肾病

［Abstract］Objective In order to explore the prevention and treatment of type 2 diabetes mellitus，herein we want to discuss relevance factors between hyper-homocysteine and type 2 diabetes.Methods 201 patients with type 2 diabetes mellitus were selected who were diagnosed according to diabetes treatment guidelines.They were compared with 65 healthy persons excluded diabetes.The levels of the serum homocysteine concentration，triglyceride，total cholesterol and low density lipoprotein cholesterol were detected，respectively.The glycosylated hemoglobin，fundus，renal function（chemiluminescence），blood glucose of the patients were also measured and analyzed using statistical method.The interrelations of serum homocysteine，diabetic microangiopathy，diabetic macroangiopathy with diabetes were discussed.Results The blood homocysteine levels in the diabetic group were higher than those in the control group（14.74±7.11%vs 9.86±3.8064%）（P＜0.05）（17.08±8.95%vs 9.86±3.80%）（P＜0.05）.Blood homocysteine level in diabetic nephropathy group was higher than that in control group.The blood homocysteine levels in type 2 diabetic patients with carotid plaque were also higher than the control group（21.39±8.82%vs 9.86±3.80%），（P＜0.05）.There are not statistically significant differences between Hcy with age，TC，TG，HDL-C or LDL-C.Conclusion Homocysteine is a risk factor for type 2 diabetes mellitus and is the promoting factor of diabetic nephropathy.Hcy plays an important role in the development of atherosclerosis in patients with diabetes.

［Key words］Type 2 diabetes；Serum homocysteine；Carotid plaque；Diabetic nephropathy

中国糖尿病发病率属于亚洲最高的国家之一，且我国糖尿病直接卫生费巨大，必须采取有效措施减轻患者和社会的经济负担。……