糖尿病神经性膀胱外周血同型半胱氨酸、叶酸及维生素B_(12)的变化及与膀胱功能的相关性

Changes in the expressions of serum homocysteine,folic acid and vitamin B_(12) in diabetic neurogenic bladder and the relationship with bladder function

目的探讨血清同型半胱氨酸(homocysteine,Hcy)、叶酸(folic acid,FA)、维生素B_(12)(vitamin B_(12),VitB_(12))在糖尿病神经性膀胱(diabetic neurogenic bladder,DNB)患者中的变化及与其膀胱功能的相关性。方法选取2013年1月至2015年12月华中科技大学同济医学院附属梨园医院内分泌科诊治的241例2型糖尿病(type 2 diabctesmellitus,T2DM)患者,其中DNB患者94例,非DNB患者147例,检测2组患者的血清Hcy、FA及VitB_(12),并分析上述指标与DNB患者的膀胱功能的相关性。结果 DNB组患者的Hcy[(24.00±8.20)μmol/L]、空腹血糖(fasting plasma glucose,FPG)[(9.17±2.00)mmol/L]和三酰甘油(triglyceride,TG)[(2.24±0.75)mmol/L]水平显著的高于非DNB组患者[(11.66±4.47)μmol/L、(7.40±1.98)mmol/L、(1.62±0.50)mmol/L](P<0.05);DNB组患者的FA、VitB_(12)和空腹胰岛素(fasting insulin,Fins)水平[(15.01±4.45)μg/L、(246.92±84.00)μg/L、(0.81±0.26)m U/L]显著的低于非DNB组患者[(23.46±5.72)μg/L、(340.51±109.84)μg/L、(0.63±0.31)m U/L](P<0.05);DNB组患者的膀胱功能性尿道长度(functional urethral length,FUL)、最大尿道压(maximum urethral pressure,PMU)显著高于非DNB组患者(P<0.05);DNB组患者的膀胱顺应性(bladder compliance,BC)水平显著的低于非DNB组患者(P<0.05);DNB组患者的FA及VitB_(12)与患者的BC呈正相关性(P<0.05),Hcy与BC呈负相关性(P<0.05);PMU与FA及VitB_(12)呈负相关性(P<0.05),与Hcy呈正相关性(P<0.05)。结论 Hcy、FA和VitB_(12)在DNB患者中发生显著的改变,并与患者的膀胱功能具有一定的相关性。

Objective To investigate changes in the expressions of serum homocysteine(Hcy),folic acid(FA) and vitamin B_(12)(VitB_(12)) in the patients with diabetic neurogenic bladder(DNB) and the relationship with bladder function.Methods Chosen for the study were 241 patients of type 2 diabetes mellitus(T2DM) admitted into the hospital for treatment from January 2013 to December 2015,of whom 94 were DNB patients(the DNB group) and 147 were non-DNB patients(the non-DNB group).Serum Hcy,FA and VitB_(12) were detected in the patients of the 2 groups,and the correlation between serum Hcy,FA and VitB_(12) and bladder function of the DNB patients was analyzed in the study.Results The levels of serum Hcy [(24.00±8.20) μmol/L],fasting plasma glucose(FPG)[(9.17±2.00) mmol/L]and triglyceride(TG) [(2.24±0.75) mmol/L]in the patients of the DNB group were significantly higher than those of the non-DNB group [(11.66±4.47) μmol/L,(7.40±1.98) mmol/L and(1.62±0.50) mmol/L](P<0.05).The levels of folic acid(FA)(15.01±4.45) μg/L,VitB_(12)(246.92±84.00) μg/L and fasting insulin(Fins)(0.81±0.26) mU/L in the patients of the DNB group were significantly lower than those of the non-DNB group [(23.46±5.72) μg/L,(340.51±109.84) μg/L and(0.63±0.31) m U/L](P<0.05).The bladder functional urethral length(FUL) and maximum urethral pressure(PMU) in the patients of the DNB group were significantly higher than those of the non-DNB group(P<0.05).The level of bladder compliance(BC) for the patients of the DNB group was obviously lower than that of the patients in the non DNB group(P<0.05).In the patients of the DNB group,the levels of FA and VitB_(12) were positively correlated with BC(P<0.05),the level of Hcy was negatively correlated with the level of BC,PMU was negatively correlated with FA and VitB_(12),and PMU was positively correlated with Hcy(P<0.05).Conclusion The expression levels of Hcy,FA and VitB_(12) changed considerably,in the patients of the DNB group,and they were closely correlated with the bladder function of the patients.