初诊2型糖尿病患者血清胱抑素C的变化及影响因素的研究  

The Serum Cystatin C Change Rule of Type 2 Diabetes Mellitus of First Diagnosis

作　　者：彭郑超 张爱军 

机构地区：[1]武昌医院内2科,湖北省武汉市430063

出　　处：《实用心脑肺血管病杂志》2012年第9期1467-1468,共2页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：武汉市卫生局基金资助项目(WX10C29)

摘　　要：目的研究初次诊断为2型糖尿病患者的血清胱抑素C变化规律,并探讨其影响因素。方法以2008年10月—2011年6月在我院内分泌科就诊的108例初诊2型糖尿病患者为观察组,按入选时的尿微量清蛋白水平分为尿微量清蛋白升高亚组48例,尿微量清蛋白正常亚组60例。以同期门诊体检健康者30名作为对照组。用免疫比浊法测定血清胱抑素C和尿微量清蛋白水平。同时测定受试者的血糖、血脂、血压、体质指数、血清肌酐、血尿酸、肾小球滤过率(GFR)等生化指标,并在3组间进行比较。结果 (1)观察组中两个亚组的血清胱抑素C水平均高于对照组,差异均有统计学意义(P<0.05)。尿微量清蛋白升高亚组的胱抑素C水平高于尿微量清蛋白正常亚组,差异有统计学意义(P<0.05)。(2)在观察组中进行单因素分析显示,胱抑素C与收缩压(SBP)、低密度脂蛋白胆固醇(LDL-C)、体质指数(BMI)、糖化血红蛋白(HbA1c)、吸烟、尿微量清蛋白(MALB)呈正相关,与GFR呈负相关。(3)多元逐步回归显示:SBP、HbA1C、GFR为影响胱抑素C显著因素。结论胱抑素C患者自罹患2型糖尿病就开始升高,除反映肾小球滤过率外,与尿微量清蛋白以及部分糖尿病肾病的危险因子呈正相关,是检测初诊2型糖尿病患者肾功能变化的新的内源性指标。Objective To investigate the serum cystatin C change rule of first diagnosis′s type 2 diabetes mellitus,and discusses its influencing factor.Methods To chose the 108 cases first diagnosis type 2 diabetes mellitus as an observation group from October 2008 to June 2011 in my hospital internal medicine 2 department.According to the urine micro albumin level in screening time,divides into the urine micro albumin rising sub-group 48 cases and urinates the micro albumin normal sub-group 60 cases.Take the same time outpatient service physical examination healthy persons 30 celebrated works as the control group.Blood serum cystatin C and the urine micro albumin level make used of the immunity turbidimetric method.We determined simultaneously the biochemical indexes blood sugar,blood lipids,blood pressure,body mass index,serum creatinine,blood uric acid,glomerular filtration rate,and carries on the comparison during three groups.Results（1） in two the sub-groups of the observation group blood serum cystatin C are higher than the control group,the difference have statistics significance（P〈0.05）.The serum cystatin C in the urine micro albumin rising sub-group be higher than the urine micro albumin normal sub-group,the difference has statistics significance（P〈0.05）.（2） The single factor analysis in the observation group demonstrate that serum cystatin C and SBP,LDL-C,BMI,HbA1c,smoking,MALB were positive correlation,and GFR was the inverse correlation.（3） The multi-dimensional stepwise regression demonstrated： SBP,HbA1C,GFR is the influence serum cystatin C remarkable factor.Conclusion Serum cystatin C suffers starts to rise from falling in type 2 diabetes mellitus.Besides reflects the glomeruluar filtration rate,is related with the urine micro albumin as well as the partial diabetes nephrosis′s dangerous factor,is monitors the first diagnosis 2 diabetic kidney function change the new endocardial target.

关 键 词：糖尿病 2型 胱抑素 尿微量清蛋白 

分 类 号：R587.1[医药卫生—内分泌]