2型糖尿病肾病患者胱抑素C、同型半胱氨酸、血管紧张素Ⅱ与尿蛋白排泄量相关性分析  

Correlation analysis of serum cystatin C,homocysteine,angiotensinⅡand urinary protein excretion in patients with type 2 diabetic nephropathy

作　　者：杨超茅 杨志新 程雯 YANG Chaomao;YANG Zhixin;CHENG Wen(Department of Geriatrics,Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201999,China)

机构地区：[1]上海市宝山区中西医结合医院老年病科,上海201999

出　　处：《世界临床药物》2021年第12期1098-1102,共5页World Clinical Drug

基　　金：宝山区卫生和计划生育委员会课题:宝山区名中医传承工作室项目(BSMZYGZS-201910);宝山区科学技术委员会科技创新专项资金医学卫生项目:基于ACE/AngⅡ/AT1R轴探讨糖肾地黄汤治疗早期糖尿病肾病的作用机制(20-E-14);上海市卫生健康委员会科研课题:糖肾地黄汤治疗肾阴虚型糖尿病肾病的临床疗效观察及对肠道菌群的作用机制(20214Y0195)。

摘　　要：目的研究2型糖尿病(type 2 diabetes mellitus,T2DM)肾病(diabetic nephropathy,DN)患者胱抑素C(cystatin C,Cys-C)、同型半胱氨酸(homocysteine,Hcy)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)与尿蛋白排泄量的相关性。方法收集2018年1月至2019年8月于本院确诊T2DM的112例患者的临床资料。根据尿白蛋白/肌酐比值(urine albuminto-creatinine ratio,UACR)分为3组:正常蛋白尿组36例(UACR<30μg/mg·Cr),微量蛋白尿组39例(UACR为30~300μg/mg·Cr),临床蛋白尿组37例(UACR>300μg/mg·Cr)。选择同期健康体检者35例作为对照组。检测并分析Cys-C、Hcy、AngⅡ与尿蛋白排泄量的相关性。结果正常蛋白尿组、尿蛋白排泄率、临床蛋白尿组Cys-C、Hcy、AngⅡ水平逐渐升高,且都与DN的独立危险因素UA、尿微量白蛋白呈正相关(P<0.05)。Hcy、AngⅡ与糖化血红蛋白呈明显正相关(P<0.05)。结论关注2型DN患者的Cys-C、Hcy、AngⅡ水平有利于更灵敏地早期检测DN患者的肾脏损害,对患者长期预后甚有帮助。Objective To study the correlation between urinary protein excretion and serum cystatin C(Cys-C),homocysteine(Hcy),angiotensinⅡ(AngⅡ)in type 2 diabetic mellitus(T2DM)nephropathy(DN)patients.Methods The clinical data of 112 patients with T2DM diagnosed in our hospital from January 2018 to August 2019 were collected.According to urinary albumin to creatinine ratio(UACR),they were divided into three groups:36 cases in normal proteinuria group(UACR<30μg/mg·Cr),39 cases in microalbuminuria group(UACR 30~300μg/mg·Cr),37 cases in clinical proteinuria group(UACR>300μg/mg·Cr).Thirty five healthy persons in the same period were selected as the control group.The correlation between Cys-C,Hcy,AngⅡand urinary protein excretion was detected and analyzed.Results The levels of Cys-C,Hcy and AngⅡin normal proteinuria group,microalbuminuria group and clinical proteinuria group increased gradually,and were positively correlated with UA and urinary protein excretion rate(P<0.05).Hcy and AngⅡwere positively correlated with glycosylated hemoglobin(P<0.05).Conclusion Paying attention to the levels of Cys-C,Hcy and AngⅡin patients with type 2 DN is conducive to more sensitive early detection of renal damage in patients with DN,which is very helpful for the long-term prognosis of patients.

关 键 词：糖尿病肾病 胱抑素C 同型半胱氨酸 血管紧张素Ⅱ 

分 类 号：R587.1[医药卫生—内分泌] R587.2[医药卫生—内科学]