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目的探讨糖尿病肾病患者同型半胱氨酸(Hcy)水平及升高的相关因素。方法选择2型糖尿病合并糖尿病肾病患者、无肾病2型糖尿病患者和正常对照组各60例进行血清Hcy检测,并比较各组Hcy水平;糖尿病肾病组测定同型半胱氨酸、血红蛋白、前白蛋白、血浆白蛋白、总胆固醇、低密度脂蛋白、甘油三酯、肌酐、尿素氮、尿酸、24 h尿蛋白、糖化血红蛋白及超敏C反应蛋白等指标,分析Hcy与这些指标的相关性。结果糖尿病肾病组血清Hcy水平为(24.08±5.09)mmol/L,明显高于2型糖尿病组(16.20±5.3)mmol/L和正常对照组(6.85±3.07)mmol/L(P<0.01)。糖尿病肾病组患者的Hcy水平与24 h尿蛋白定量(r=0.541,P=0.003)和超敏C反应蛋白(r=0.698,P=0.001)存在相关。结论大量蛋白尿引起营养不良和血管微炎症状态,可能是糖尿病肾病患者Hcy升高的重要原因。
Objective To investigate the correlation between the level of homocysteine (Hcy) and the elevation in patients with diabetic nephropathy. Methods Sixty patients with type 2 diabetes mellitus and type 2 diabetes mellitus without diabetes mellitus and normal controls were enrolled in this study. Serum Hcy levels were measured and the levels of Hcy in each group were compared. Homocysteine, hemoglobin, prealbumin , Serum albumin, total cholesterol, low density lipoprotein, triglyceride, creatinine, urea nitrogen, uric acid, 24 h urinary protein, glycosylated hemoglobin and high sensitivity C-reactive protein and other indicators, analysis of Hcy and these indicators. Results Serum Hcy level in diabetic nephropathy group was (24.08 ± 5.09) mmol / L, which was significantly higher than that in type 2 diabetes group (16.20 ± 5.3) mmol / L and normal control group (6.85 ± 3.07) mmol / L group (P <0.01). The level of Hcy in patients with diabetic nephropathy was correlated with 24 h urine protein (r = 0.541, P = 0.003) and high sensitivity C reactive protein (r = 0.698, P = 0.001) Conclusion A large number of proteinuria cause malnutrition and microvascular inflammation, which may be an important reason for the increased Hcy in patients with diabetic nephropathy.