DM2及合并肾病患者血浆Hcy及尿Alb水平的变化

Changes of Plasma Levels of Homocysteine (Hcy) and Urinary Albumin Contents in Patients with Type 2 Diabetes Complicated with Nephropathy

目的:探讨2型糖尿病(DM2)及合并肾病患者同型半胱氨酸(Hcy)的变化情况。方法:设正常对照组、无并发症糖尿病组、合并肾病组三组,比较三组间血清Hcy的水平。结果:两组糖尿病患者间空腹血糖水平无显著差异;BUN和Cr在三组间无差异,但糖尿病合并肾病患者尿Alb较无并发症组明显升高(P<0.01);糖尿病各组血清总Hcy浓度均明显高于正常对照组(P均<0.01),其中合并肾病患者增高更为明显,与无并发症组亦有明显差异(P<0.01)。结论:在两组糖尿病患者中Hcy均有明显增高,且在有肾病合并症的患者中不仅尿Alb比无合并症患者明显增高,Hcy也明显增高,但肾功能损伤并未进入失代偿期,在临床上有必要对糖尿病患者检测血浆总Hcy水平,及时进行干预治疗,从而预防或缓解糖尿病的进一步发展。

Objective To study the changes of plasma levels of homocysteine （Hcy） and urinary albumin contents in patients with type 2 diabetes complicated with nephropathy. Methods Plasma Hcy （with fluorescence immunoassay） fasting glucose, BUN, Cr （with biochemistry） levels and urinary albumin contents （with RIA） were determined in 36 DM2 patients without nephropathy, 30 DM2 patients with nephropathy and 30 controls. Results The fasting blood glucose levels in the 2 groups of diabetic patients were not much different. Again, the BUN and Cr levels in the 3 groups of patients were about the same. The plasma Hcy levels in the group of patients with diabetic nephropathy were significantly higher than those in both controls and DM2 patients without nephropathy （all P0.01）. Conclusion Hyperhomocysteinemia is a risk factor for nephropathy in DM2 patients.