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随机选择T2DM患者120例(DM组),将其进一步分为单纯糖尿病组(NDN组,45例)和糖尿病肾病组(DN组,75例);选择健康体检者60例作为健康对照组(对照组)。记录所有观察对象体重指数(BMI)、空腹肝功(ALT、AST)、空腹血清血糖(FPG)、糖化血红蛋白(HbA1c)、胆红素(TBIL、DBIL、IBIL)、24小时尿微量白蛋白定量(mALB)数值。结果①DM组的HbA1c、mALB较对照组明显升高,而胆红素明显降低,差异有统计学意义(P<0.05)。DN组的HbA1c较NDN组明显升高,而胆红素明显降低,差异有显著性意义(P<0.01)。②NDN组的胆红素与其糖化血红蛋白无明显线性关系。而DN组的胆红素与糖化血红蛋白呈负相关。结论糖尿病患者血中胆红素水平可反映患者糖代谢控制的情况。胆红素水平降低与糖尿病肾病的发生、发展可能存在某种联系。联合监测患者血胆红素、尿mALB,对早期诊断及控制糖尿病肾病有明显意义。
A total of 120 T2DM patients (DM group) were randomly selected and divided into diabetic group (NDN group, 45 cases) and diabetic nephropathy group (DN group, 75 cases). Sixty healthy subjects were selected as healthy control group group). The body mass index (BMI), fasting liver function (ALT, AST), fasting serum glucose (FPG), HbA1c, TBIL, DBIL and IBIL were recorded and the urinary microalbuminuria (mALB) value. Results ① The levels of HbA1c and mALB in DM group were significantly higher than those in control group, while the bilirubin was significantly lower in DM group (P <0.05). HbA1c in DN group was significantly higher than that in NDN group, but bilirubin was significantly lower in DN group (P <0.01). ② NDN group of bilirubin and its glycosylated hemoglobin no significant linear relationship. The DN group of bilirubin and glycated hemoglobin was negatively correlated. Conclusion The level of bilirubin in the blood of diabetic patients can reflect the patients’ glycometabolism control. Bilirubin levels and the development of diabetic nephropathy may have some connection. Joint monitoring of patients with serum bilirubin, urinary mALB, early diagnosis and control of diabetic nephropathy have significant significance.