以LP(a)为指标进行的糖尿病慢性并发症的预防  

LP(a) as a Index of prevention of Chronic Complication of 2Type Diabetes Mellitus

作　　者：王彦君[1] 陈曦[1] 迟宝荣[1] 

机构地区：[1]吉林大学第一医院消化内科,吉林长春130021

出　　处：《中国实验诊断学》2008年第3期363-366,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨通过对2型糖尿病患者的干预处理,确定其对血浆中脂蛋白[LP(a)]浓度是否有影响,并确定监测LP(a)对2型糖尿病慢性并发症能否起到预防作用。方法选择我院2003年7月至2006年10月间门诊及入院的2型糖尿病患者130例作为研究对象,门诊体格检查中选出120名健康者作为正常对照组,清晨采静脉血,测血糖、糖化血红蛋白(HbA1C)、总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、尿素氮(BUN)、血肌酐(Cr)、C-肽水平、载脂蛋白AI(ApoAI)、载脂蛋白B(ApoB)、脂蛋白(a)[LP(a)]。干预组给予降脂药及钙拮抗剂治疗,间隔3个月复查上述相关指标,并随访两组患者心、脑血管疾病的发生情况。结果干预处理前,2型糖尿病总组中LDL-C、TG、TC、GHbA1C、空腹C-肽、血糖、LP(a)水平高于正常对照组,两者比较有显著差异性,(P<0.05,P<0.01)。干预处理9个月后,干预组中LP(a)、LDL-C,ApoB下降程度与非干预组中相应指标比较有显著差异性(P<0.05)。结论干预治疗对2型糖尿病患者中高LP(a)水平有效,干预治疗,可能降低2型糖尿病心、脑血管疾病的发生的危险性,监测LP(a)对2型糖尿病慢性并发症能起到预防作用。Objective To investigate the effect to concentration of lipoprotein（LP） （a） through intervention in patients with 2- type diabetes mellitus,and to definite if monitoring LP（a）could paly a preventative effect to 2-type diabetes mellitus＇ chronic complication. Methods 1Totally 130 out-patients and in-patients with 2-type diabetes mellitus in our hospital from July 2003 to October 2006 were selected as research object, and 120 healthy persons which came from out-patient clinic medical examination were selected as normal control group. Venous blood of all subjects were taken in the morning, and blood glucose, glycosylated hemoglobin, total cholesterol, triglyeride, low density lipoprotein, high density lipoprotein, urea nitrogen, C- peptide, apolipoprotein AI, apolipoprotein B and LP（a） were determined. Lipocaic drugs and calcium antagonist were given to intervention group. Correlated indexes which abovementioned were rechecked interval three months,and patents of the two groups were follow-up visit in order to comprehend the development of cardiovascular and cerebrovaseular disease. Results The lever of LDL-C, TG, TC, GHbA1 C, C- peptide, blood glucose and LP（a） of all 2-type diabetes mellitus groups were higher than those of normal control group before, intervention.There were significant difference between them（ P 〈 0.05, P 〈 0.01） .There were significant difference between intervention group and without intervention group in fall degree of LP（a）, LDL-C and ApoB after nine months（ P 〈 0.05）. Conclusion The intervention is valuable to 2-type diabetes meUitus with high LP（a） and it can prevent occurrence of chronic complication.The assay of LP（a） can be used to prevent the occurrence of chronic compications of 2-type diabetes mellitus.

关 键 词：糖尿病 2型 脂蛋白(a) 干预治疗 慢性并发症 

分 类 号：R587.2[医药卫生—内分泌]