2型糖尿病患者血浆总同型半胱氨酸水平与大血管病变的关系  

The level of plasma total homocysteine in type 2 diabetes and its relationship with macrovascular diseases

作　　者：周灵丽[1] 卢纹凯[1] 

机构地区：[1]北京大学人民医院内分泌科,100044

出　　处：《中国糖尿病杂志》2003年第4期265-267,共3页Chinese Journal of Diabetes

摘　　要：目的　探讨 2型糖尿病患者 (T2 DM)血浆总同型半胱氨酸 (st Hcy)水平、影响因素及其与大血管病变的关系。　方法　对 1 91例 T2 DM患者及 2 3名正常对照人群采用高压液相层析方法测定 st Hcy、B型超声检查测定颈动脉内膜中层厚度 (IMT) ,并测定各临床、生化参数。　结果　 (1 )T2 DM患者组 st Hcy总体水平与正常对照组比较差异无显著意义 (P=0 .31 )。其中 st Hcy≥ 1 5 .1μm ol/L 组的年龄、高血压病程、血清肌酐、尿酸、尿白蛋白排泄率、IMT增厚发生率较 st Hcy<1 5 .1μm ol/L 组高 ,肾小球滤过率、糖化血红蛋白较 st Hcy<1 5 .1 μm ol/L 组低 (P<0 .0 0 1～ 0 .0 5 )。(2 ) IMT增厚组 st Hcy和高 st Hcy百分率较 IMT正常组和正常对照组明显增高 (P<0 .0 5～ 0 .0 0 1 )。多元逐步线性回归分析显示 ,st Hcy与 IMT增厚呈独立相关。 (OR=1 .36 5 ,P<0 .0 0 1 ,95 %可信区间 1 .1 39～1 .6 37)。　结论　 T2 DM患者 st Hcy受病程不同阶段的多种因素影响。stObjective To investigate the plasma total homocystein (stHcy) level, its affecting factors and its relationship with macrovascular diseases in type 2 diabetecs. Methods The stHcy concentration was determined by HPLC method. The intimal medial thikeness(IMT) of common carotid artery was measured by ultrasonography. The clinical and biochemical data were analysed. Results (1)The stHcy level in group of type 2 diabetics was not different from controls ( P >0.5) The age, duration of high blood pressure, serum creatinine, serum uric acid, urine albumin excretive rate,the percentage of patients with IMT 0.8 mm were higher in group of stHcy 15.1 μmol/L. The glumerular filtration rate, glucosyleted hemoglubulin A1c were lower than those in group of stHcy<15.1 μmol/L significantly( P <0.05-0.001) (2)The stHtcy level and the percentage of high stHcy in group of thickened IMT was higher than those in normal IMT group and controls( P <0.05～0.001). Multiple linear regresson analysis showed that the stHcy correlated with IMT independently Conclusions The stHcy in diabetic patients was affected by different factors, The high level of stHcy is independent risk factor for macrovascular disease in type 2 DM.

关 键 词：2型糖尿病 血浆 总同型半胱氨酸 大血管病变 影响因素 高压液相层析法 B型超声 

分 类 号：R587.1[医药卫生—内分泌]