2型糖尿病肾病患者血清同型半胱氨酸及糖化血红蛋白水平与肾脏功能的相关性分析  

Correlation analysis of homocysteine and glycosylated hemoglobin and renal function in patients with type 2 diabetic nephropathy

作　　者：张国庆 鄂静[1,2] 李博 保莉[1,2] 郑亚莉 ZHANG Guoqing;E Jing;LI Bo;BAO Li;ZHENG Yali(Nephrology Department,People’s Hospiital affiliated to Ningxia Medical University,Yinchuan 750002,China;The First Clinical Medical College of Northwest University for Nationalities,Yinchuan 750002,China)

机构地区：[1]宁夏医科大学附属自治区人民医院肾内科,宁夏银川750002 [2]西北民族大学第一附属医院,宁夏银川750002

出　　处：《宁夏医学杂志》2021年第10期875-877,共3页Ningxia Medical Journal

基　　金：国家自然科学基金(81860136);宁夏自然科学基金资助项目(020AAC03334,2020AAC03330,NZ17186);宁夏回族自治区重点研发计划重大重点项目(东西部合作2018BFG02010);宁夏回族自治区人民医院培育振兴科研项目(201911)。

摘　　要：目的探讨2型糖尿病肾病患者血清同型半胱氨酸及糖化血红蛋白水平与肾脏功能进展的关系。方法收集104例2型糖尿病肾病住院患者血尿素氮(BUN)、血清肌酐(Scr)、血尿酸(BUA)、血同型半胱氨酸(Hcy)、糖化血红蛋白(HbA 1c)、估算肾小球滤过率(eGFR)、尿微量白蛋白(UMA)等资料,根据UMA检测值,分为微量白蛋白尿组40例(UMA 20~300 mg/L)和临床蛋白尿组64例(UMA>300 mg/L),分析比较2组之间各临床指标水平的变化,并通过Pearson相关分析法探讨血清同型半胱氨酸、糖化血红蛋白水平与其他临床指标之间的关系。结果临床蛋白尿组患者的血清肌酐、尿素氮、尿酸、血同型半胱氨酸、糖化血红蛋白显著高于微量白蛋白尿组(P<0.05),而eGFR明显降低。Pearson相关分析显示,血同型半胱氨酸水平与血清肌酐、尿素氮、尿酸呈正相关(r=0.417、0.612、0.285,P<0.05),与eGFR呈负相关(r=-0.493,P<0.05);糖化血红蛋白水平与血清肌酐、尿素氮、尿酸呈正相关(r=0.315、0.197、0.092,P<0.05),与eGFR呈负相关(r=-0.274,P<0.05)。结论血清同型半胱氨酸、糖化血红蛋白水平与2型糖尿病肾病的发生、发展相关,2型糖尿病肾病患者的血清同型半胱氨酸及糖化血红蛋白水平能够评估、监测肾脏功能进展的情况,具有重要的临床价值。Objective To discuss the correlation between the level of homocysteine(Hcy)and glycosylated hemoglobin(HbA1c)and renal function in patients with type 2 diabetic nephropathy.Methods 104 patients with type 2 diabetic nephropathy were selected and the Blood urea nitrogen(BUN),serum creatinine(Scr),serum uric acid(UA),blood homocysteine(Hcy),glycosylated hemoglobin(HbA1c),estimated glomerular filtration rate(eGFR)and urinary microalbumin(UMA)were detected,according to the level of UMA,they were divided into microalbuminuria group(UMA 20~300 mg/L,n=40)and clinical proteinuria group(UMA>300 mg/L,n=64).The changes of clinical indexes between the two groups were analyzed and compared,and the correlation between the level of Hcy and glycosylated hemoglobin and other clinical indexes was discussed by Pearson correlation analysis.Results Compared with microalbuminuria group,the patients in clinical proteinuria group had significantly higher level of Scr、BUN、UA、Hcy、HbA1c(P<0.05),while eGFR decrease significantly.Pearson correlation analysis showed that the levels of Hcy in serum were positively correlated with SCr、BUN、UA(r=0.417,0.612 and 0.285,respectively,P<0.05),while negatively correlated with eGFR(r=-0.493,P<0.05).The levels of HbAlc in serum were positively correlated with SCr、BUN、UA(r values were 0.315,0.197 and 0.092,respectively,P<0.05),while negatively correlated with eGFR(r=-0.274,P<0.05).Conclusion The levels of Hcy and HbAlc are related to the occurrence and development of type 2 diabetic nephropathy.The level of serum Hcy and HbAlc can evaluate and monitor the progress of renal function of patients with type 2 diabetic nephropathy.

关 键 词：同型半胱氨酸 糖化血红蛋白 尿微量白蛋白 糖尿病肾病 

分 类 号：R692[医药卫生—泌尿科学]