通过HbA1c和Hs-CRP和Hcy及UREA水平变化评估2型糖尿病肾病的发生风险  

Risk assessment of type 2 diabetic nephropathy by changes of HbA1c, Hs-CRP, Hcy and UREA levels

作　　者：侯海燕[1] 李军鹰[1] 曹锦梅[2] 

机构地区：[1]淮安市疾病预防控制中心检验科,江苏淮安223002 [2]南京医科大学附属淮安第一人民医院检验科

出　　处：《中国校医》2017年第9期675-677,679,共4页Chinese Journal of School Doctor

摘　　要：目的根据检测血液中糖化血红蛋白(HbA1c)、超敏C反应蛋白(Hs-CRP)、同型半胱氨酸(Hcy)和尿蛋白排泄率(UREA)水平来评估2型糖尿病肾病发生的风险率。方法随机选取淮安市第一人民医院2016年1月-12月份收治的2型糖尿病患者83例为实验组,根据尿蛋白排泄率(UREA)分为单纯糖尿病组和糖尿病肾病组并与90例健康人群进行对比,观察2组HbA1c、Hs-CRP、Hcy、及UREA水平的变化。结果实验组HbA1c、Hs-CRP、Hcy、及UREA水平均高于对照组,结果分别为HbA1c(8.99±2.26)%、Hs-CRP(7.38±4.04)mg/L、Hcy(15.12±5.17)μmol/L、UREA(152.66±98.70)mg/24 h,阳性检出率分别为;HbA1c53.01%、Hs-CRP50.60%、Hcy49.40%、UREA42.17%;同时糖尿病肾病组4项指标也明显高于单纯糖尿病组,结果分别为糖尿病肾病组HbA1c(10.72±2.53)%,、Hs-CRP(10.27±3.34)mg/L、Hcy(20.38±4.20)μmol/L、UREA(295.69±86.82)mg/24 h,阳性检出率分别为HbA1c72.50%、Hs-CRP70.00%、Hcy67.50%、UREA87.50%,差异有统计学意义(P<0.05)。结论血液Hcy、Hs-CRP、HbA1c及UREA与2型糖尿病肾病的发生、发展紧密相关.HbA1c、Hs-CRP、Hcy及UREA的水平越高,糖尿病肾病发生的风险性越大,动态观察以上4项指标对糖尿病肾病早期诊断、病情发展的分析和监测具有重要的意义。Objective To assess the risk of type 2 diabetic nephropathy by changes of glycosylated hemoglobin（Hb A1c）, high sensitive C reactive protein（Hs-CRP）, homocysteine（Hcy） and urinary protein excretion rate（UREA） levels.Methods Totally 83 type 2 diabetes patients were selected as an experimental group in the First People＇s Hospital of Huaian City from January to December, 2016, and 90 healthy people were selected as a control group. The patients in the experimental group were divided into a simple diabetes sub-group and a diabetic nephropathy sub-group according to UREA. The changes of HbA1c, Hs-CRP, Hcy and UREA levels were detected. Results The levels of HbA1c, Hs-CRP, Hcy and UREA in the experimental group were higher than those in the control group. In the experimental group, the aver-age values of HbA1c, Hs-CRP, Hcy and UREA were（8.99±2.26） %,（7.38±4.04） mg/L,（15.12±5.17） umol/L and（152.66±98.70） mg/24 h, respectively. The positive detection rates of HbA1c, Hs-CRP, Hcy and UREA were 53.01%, 50.60%,49.40% and 42.17%, respectively. At the same time, the four indexes in the diabetic nephropathy sub-group were significantly higher than those in the simple diabetes sub-group and the difference was statistically significant（P〈0.05）. In the diabetic nephropathy sub-group, the average values of HbA1c, Hs-CRP, Hcy and UREA were（10.72±2.53） %,（10.27±3.34）mg/L,（20.38±4.20） umol/L and（295.69±86.82） mg/24 h, respectively. The positive detection rates of HbA1c, Hs-CRP, Hcy and UREA were 72.5%, 70.0%, 67.5% and 87.5%, respectively. Conclusion The serum levels of Hcy, Hs-CRP, HbA1c and UREA are closely related to the occurrence and development of type 2 diabetic nephropathy. The higher of the levels of HbA1c, Hs-CRP, Hcy and UREA, the greater of the risk of diabetic nephropathy. The dynamic observation of the above four indicators has a significance in the early diagnosis of diabetic nephropathy, and the analysis and monitoring of the progression of the disease.

关 键 词：糖尿病肾病/诊断 危险性评估 血红蛋白A 糖基化/血液 C-反应蛋白质/血液 高半胱氨酸/血液 白蛋白尿 

分 类 号：R589[医药卫生—内分泌]