糖尿病微血管病变患者血浆同型半胱氨酸水平及影响因素  

The plasma homocysteine level and its influencing factors in diabetes patients with microanigiopathy

作　　者：邱云霞[1] 于凤泉[1] 

机构地区：[1]山东省临沂市沂水中心医院,276400

出　　处：《中国实用医刊》2011年第2期5-6,共2页Chinese Journal of Practical Medicine

摘　　要：目的观察糖尿病微血管患者血浆同型半胱氨酸（Hcy）水平的影响因素，探讨Hcy在预测糖尿病慢性并发症中的地位和意义。方法将确认的糖尿病患者根据慢性并发症不同分为糖尿病肾病组（B组）、糖尿病眼病组（C组）、糖尿病外周神经病变组（D组）和多种慢性并发症（E组），无慢性并发症的糖尿病患者为A组，并设健康对照组。采空腹血分别监测Hcy、叶酸（FA）、维生素B12（VitB12）、糖化血红蛋白（HbAlc）、空腹血糖（FBG）、餐后2h血糖（PBG）及肌酐（Scr）、总胆固醇、甘油三酯、尿微量白蛋白及胫腓神经传导速度，并进行统计学处理和影响Hcy因素多元回归分析，探讨危险因素。结果有慢性并发症组Hcy明显升高，微血管并发症越重，Hcy越高，但无慢性并发症糖尿病患者与正常对照组Hcy比较差异无统计学意义，并指出影响Hcy水平的因素为FA、VitB12、Scr、PBG及HbAlc，与FBG无关，认为FA、VitB12、Scr、PBG均为糖尿病眼病独立危险因素。结论Hcy可作为预测糖尿病慢性微血管并发症的危险因子，动态观察在糖尿病微血管病变中具有重要意义。糖尿病微血管病者补充FA、VitB12可降低血浆Hcy浓度，减轻Hcy对微血管病变的影响。Objective To observe the plasma Hcy level and its influencing factors in diabetes patients with microanigiopathy, and to inquire into the position and meaning of Hcy in predicting the chronic diabetes complications. Methods According to the different chronic diabetes complications, the diabetes patients were divided into five groups, diabetic nephropathy （group B）, diabetic retinopathy （group C）, diabetic neuropathy （group D）, diabetes patients with multiple complications （group E）, establish diabetes patients without chronic complication as group A and healthy subjects as the control group. We draw the fasting blood to detect Hey, FA, VitB12, HbAlc, FBG, PBG, TG, CH and Scr. Microalbuminuria （MAV） and nerve conduct velocity （NCV） were measured simultaneously. Results The Hcy level was obviously high in diabetes patients with chronic complication, the Hcy level was higher, but there was no statistical difference becween the diabetes patients without chronic complications and the control group. It was pointed out that FA, VitB12 , Scr, PBG and HbAlc were the influencing factors of Hcy level, FA, VitB12, Scr, PBG were regarded as the independent factors. Conclusions （1）Hcy can be regarded as the dangerous factors to predict the diabetes chronic microanigiopathy, and dynamic observation on plasma Hcy had great meaning in diabetic microanigiopathy. （2）Supplements with FA, VitB12 for the diabetes patients with microanigiopathy can decrease plasma Hcy density, relieve the influence of Hcy acting on microanigiopathy.

关 键 词：糖尿病慢性并发症 同型半胱氨酸 危险因子 

分 类 号：R587.2[医药卫生—内分泌]