尿蛋白正常的2型糖尿病患者血清胱抑素C与冠状动脉病变的关系  

The relationship between serum cystatin C and coronary artery disease in type 2 diabetes mellitus patients with normal uric protein

作　　者：王曼曼[1] 舒冏[1] 陈宣蓉[1] 穆攀伟[1] 陈燕铭[1] 曾龙驿[1] 

机构地区：[1]中山大学附属第三医院内分泌科,广州510630

出　　处：《中国医师进修杂志》2013年第30期1-4,共4页Chinese Journal of Postgraduates of Medicine

基　　金：广东省科技计划（20118031800273）

摘　　要：目的 探讨尿蛋白正常的2型糖尿病患者血清胱抑素C与冠状动脉病变的关系.方法 将126例尿蛋白正常的2型糖尿病患者根据320排动态容积CT示冠状动脉狭窄情况分为冠状动脉正常组（A组,32例）、冠状动脉粥样硬化组（B组,38例）、冠心病组（C组,56例）,对比三组间血清胱抑素C等.结果 A、B、C组血清胱抑素C水平分别为（0.89±0.27）、（1.31±0.53）、（1.54±0.62） mg/L,随着冠状动脉病变的加重逐渐升高,差异有统计学意义（P＜0.05）.将患者按血清胱抑素C水平四分位法分成三组,随着血清胱抑素C水平的逐级升高,冠状动脉病变的发生率也呈升高趋势,当血清胱抑素C水平由第75％分位数升至第100％分位数,冠状动脉病变的发生率显著升高（OR=8.32,P＜ 0.05）.多元Logistic回归分析结果显示,影响2型糖尿病患者冠心病发生的独立危险因素有高血压病史（回归系数4.135,P=0.000）、糖化血红蛋白（回归系数1.257,P=0.002）、低密度脂蛋白胆固醇（回归系数3.381,P=0.015）、胱抑素C（回归系数2.046,P=0.030）.结论 血清胱抑素C水平可能可以预测尿蛋白正常的2型糖尿病患者罹患冠心病的风险.Objective To investigate the relationship between serum cystatin C and coronary artery disease in type 2 diabetes mellitus （T2DM） patients with normal uric protein.Methods According to the coronary artery lesion diagnosed by 320-dynamic volume CT,the 126 T2DM patients with normal uric protein were divided into three groups：no coronary stenosis group （group A,32 cases）,coronary atherosclerosis group（group B,38 cases）,coronary heart disease group （group C,56 cases）.Then the serum cystatin C etc were compared among the three groups.Results The levels of serum cystatin C in group A,B,C were （0.89 ± 0.27）,（1.31 ± 0.53）,（1.54 ± 0.62） mg/L.With the increase of coronary artery lesions,it gradually increased,there was significant difference among the three groups （P 〈 0.05）.The patients were divided into three groups according to the level of serum cystatin C quartile.The incidence of coronary artery lesion in creased with the increased levels of serum cystatin C.The level of serum cystatin C increased from 75th percentile to 100th percentile,the incidence of coronary heart disease increased significantly （OR =8.32,P 〈0.05）.The result of multiple Logistic regression analysis showed that history of hypertension （regression coefficient 4.135,P =0.000）,glycosylated hemoglobin （regression coefficient 1.257,P =0.002）,low density lipoprotein-cholesterol （regression coefficient 3.381,P =0.015）,cystatin C （regression coefficient 2.046,P =0.030） were the independent risks of coronary heart disease in patients with T2DM.Conclusion The level of serum cystatin C may be a predictor for coronary heart disease in T2DM patients with normal uric protein.

关 键 词：糖尿病 2型 冠状动脉疾病 胱抑素C 320排动态容积CT 

分 类 号：R587.1[医药卫生—内分泌]