2型糖尿病患者胰岛素强化治疗前后Cys-C、Hcy的变化比较  

The comparative study of Cys-C and Hcy before and after insulin intensive treatment for type 2 diabetes mellitus

作　　者：陈利强[1] 彭林平[1] 岳文婧[1] 林志兰[1] 李叶莉[1] 施少清 CHEN Liqiang;PENG Linping;YUE Wenfing(Department of Endocrinology,The first People＇s Hospital of Huizhou City,Guangdong,Huizhou 516000,China)

机构地区：[1]广东省惠州市第一人民医院内分泌科,516000

出　　处：《河北医药》2018年第24期3712-3715,共4页Hebei Medical Journal

基　　金：惠州市科学(编号:2013W28)

摘　　要：目的探讨2型糖尿病胰岛素强化治疗前后胱抑素C(Cys-C)、同型半胱氨酸(Hcy)的变化。方法选取接受胰岛素强化治疗的2型糖尿病患者85例,同时选取体检的健康志愿者50例为对照,比较2型糖尿病患者治疗前后和健康对照血糖指标、血Hcy、Cys-C的差异,分析血Hcy、Cys-C与血糖指标的关系。结果 2型糖尿病患者治疗前的各指标均高于正常对照(P <0. 05);治疗后患者的空腹血糖、餐后2 h血糖、糖化血红蛋白、体重、BMI均低于治疗前(P <0. 05),除体重外空腹血糖、餐后2 h血糖、糖化血红蛋白、BMI与对照组比较,差异无统计学意义(P> 0. 05)。2型糖尿病患者治疗前的血Hcy和Cys-C均高于正常对照(P <0. 05),且糖尿病肾病组和糖尿病合并其他并发症组的血Hcy和Cys-C均高于无并发症组(P <0. 05),尤以肾病组Cys-C升高明显; 2型糖尿病患者治疗后的血Hcy和Cys-C均低于治疗前,差异均有统计学意义(P <0. 05)。2型糖尿病患者的血Hcy与空腹血糖呈正相关(r=0. 232,P=0. 033),血Hcy与餐后2 h血糖呈正相关(r=0. 222,P=0. 041),血Hcy与Cys-C呈正相关(r=0. 219,P=0. 042),其他各指标间均无明显相关(P> 0. 05)。结论胰岛素强化治疗前糖尿病肾病组Hcy和Cys-C升高最为明显,经强化治疗后Hcy和Cys-C均下降,Hcy和Cys-C可为强化治疗提供参考。Objective To investigate the changes of cystatin C （Cys-c） and homocysteine （Hey） levels before and after insulin intensive treatment for type 2 diabetes mellitus. Methods Eighly-five patients with type 2 diabetes mellitus who received intensive insulin therapy in our hospital from February 2015 to December 2015 were enrolled as observation group, meanwhile, the other 50 healthy volunteers were enrolled as control group. The blood glucose indexes including the serum levels of Hey and Cys-C before and after treatment in observation group and in control group were observed and compared, moreover, the correlation between serum levels of Hey,Cys-C and blood glucose indexes was analyzed. Results These indexes in observation group before treatment were significantly higher than those in control group （ P 〈 0.05 ）. The levels of fasting blood glucose, postprandial 2h blood glucose, glycosylated hemoglobin, body weight, BMI after treatment were significantly lower than those before treatment in observation group （ P 〈 0. 05 ）. Except for fasting blood glucose, there were no significant differences in the levels of postprandial 2h blood glucose, glycosylated hemoglobin, BMI between the two groups （P 〉 0.05）. The levels of blood homocysteine and Cys-C in observation group before treatment were significantly higher than those in control group （ P 〈 0.05 ） , moreover, the levels of Hey and Cys-C in diabetic nephropathy group and in combined other complications group were significantly higher than those in non-complication group （P 〈 0.05 ） , especially, the levels of Cys-C in diabetic nephropathy group were the highest. The levels of Hey and Cys-C after treatment were significantly lower than those before treatment in observation group （P 〈 0.05）. Moreover the serum levels of Hey were positively correlated to those of fasting blood glucose in observation group （ r = 0. 232, P 〈 0. 05 ） , and the serum levels of Hey were positively correlated with postprandial 2h glucose （r

关 键 词：2型糖尿病 胰岛素强化治疗 血同型半胱氨酸 胱抑素C 

分 类 号：R587.1[医药卫生—内分泌]