2型糖尿病合并高血压患者血清同型半胱氨酸及常用肾功能指标检测分析  

Detection and analysis of serum homocysteine and common renal function indexes in patients with type 2 diabetes mellitus complicated with hypertension

作　　者：何小魁[1] 万晓华[1] 张晓红[1] 耿红艳[1] 周学红[1] 刘向祎[1] HE Xiaokui;WAN Xiaohua;ZHANG Xiaohong;GENG Hongyan;ZHOU Xuehong;LIU Xiangyi(Department of Clinical Laboratory,Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院检验科,北京100730

出　　处：《国际检验医学杂志》2020年第24期2986-2989,共4页International Journal of Laboratory Medicine

基　　金：北京市卫生系统高层次卫生技术人才培养计划(2015-3-014)。

摘　　要：目的探讨2型糖尿病(T2DM)合并高血压患者血清同型半胱氨酸(Hcy)及常用肾功能指标水平的相关性。方法选取2019年3-8月在首都医科大学附属北京同仁医院治疗的T2DM患者249例作为研究对象,根据患者是否患有高血压分为合并高血压组(T2DM+高血压组,144例)和无高血压组(T2DM组,105例)。对所有患者检测血清Hcy、血清肌酐(Cr)、尿微量清蛋白/Cr(ACR)、尿免疫球蛋白G/Cr(IGU/Cr)、尿转铁蛋白/Cr(TRU/Cr)、尿α1-微量球蛋白/Cr(α1/Cr),并计算肾小球滤过率估计值(eGFR),观察两组上述指标的差异;同时对所有患者血清Hcy与肾功能指标进行相关性分析。结果T2DM+高血压组Hcy、ACR、IGU/Cr、TRU/Cr、α1/Cr水平均高于T2DM组,T2DM+高血压组eGFR低于T2DM组,差异均有统计学意义(均P<0.05)。Hcy与ACR、IGU/Cr、TRU/Cr、α1/Cr均呈正相关(r=0.133、0.125、0.125、0.218,均P<0.05),与eGFR呈负相关(r=-0.358,P<0.05)。结论T2DM合并高血压患者血清Hcy及常用反映肾功能早期损伤的检测指标水平均较单纯T2DM患者高,且Hcy与肾功能检测指标存在相关性,临床应引起重视。Objective To investigate the correlation between the serum level of homocysteine(Hcy)and common renal function indexes in patients with type 2 diabetes mellitus(T2DM)complicated with hypertension.Methods A total of 249 patients with T2DM who were treated in Beijing Tongren Hospital from March 2019 to August 2019 were divided into two groups according to whether they had hypertension including the group with hypertension(T2DM+hypertension group,144 cases)and the group without hypertension(T2DM group,105 cases).Serum Hcy,serum creatinine(Cr),urinary microalbumin/creatinine(ACR),urinary immunoglobulin G/creatinine(IGU/Cr),urinary transferrin/creatinine(TRU/Cr),urinaryα1-microglobulin/creatinine(α1/Cr)were measured in all subjects,the glomerular filtration rate(eGFR)was calculated,and the difference between the two groups was observed.At the same time,the correlation between serum Hcy and renal function indexes was analyzed.Results The levels of Hcy,ACR,IGU/Cr,TRU/Cr andα1/Cr in the T2DM+hypertension group were higher than those in the T2DM group,the eGFR level of T2DM+hypertension group was lower than that of T2DM group,the differences were statistically significant(all P<0.05).Hcy was positively correlated with ACR,IGU/Cr,TRU/Cr andα1/Cr(r=0.133,0.125,0.125,0.218 respectively,all P<0.05),and negative correlated with eGFR(r=-0.358,P<0.05).Conclusion The level of Hcy in serum of T2DM patients with hypertension and the commonly used detection indexes reflecting early renal function damage are higher than those of T2DM patients alone,and Hcy correlated with the detection indexes of renal function,which should be paid more attention in clinical practice.

关 键 词：2型糖尿病 高血压 同型半胱氨酸 尿蛋白四项 肾小球滤过率 

分 类 号：R587.1[医药卫生—内分泌]