血浆同型半胱氨酸检测及其在糖尿病肾病中的应用

Relationship between plasma homocysteine and diabetic nephropathy

目的：观察糖尿病肾病（DN）患者血浆同型半胱氨酸（Hcy）水平,分析Hcy水平与DN的关系.方法：选择DN 104例（其中合并心脑血管疾病者50例）和健康对照组38名,用循环酶法测定其血浆Hcy水平,同时检测血糖（Glu）、血肌酐（Scr）、总胆固醇（TC）、三酰甘油（TG）及高敏C反应蛋白（hs-CRP）水平.结果：DN患者血浆Hcy水平明显高于健康对照组（P〈0.01）,其中并发心脑血管疾病者Hcy及hs-CRP水平均明显高于无心脑血管疾病者（P〈0.01）.Hcy与Scr、TC、TG以及hs-CRP均呈显著正相关关系（P〈0.05~P〈0.01）.结论：DN患者血浆Hcy水平增高,Hcy可能参与了DN患者心脑血管疾病的发生;降低血浆Hcy水平,可能会减少DN患者心脑血管并发症的发生.

Objective：To observe the level of plasma homocysteine（Hcy） in patients with diabetic nephropathy（DN） and analyze the relationship between the level of Hcy and DN. Methods： The plasma Hcy level of 104 cases of DN including 50 case who were combined with heart and cerebrovascular diseases and 38 healthy controls was measured by enzymatic cycling; their blood glucose （ Glu）, serum creatinine （ Scr）, total cholesterol （ TC ）, triglyceride （TG） and high-sensitivity C-reactive protein （hs-CRP） were also measured. Results： The plasma Hcy level of patients with DN was significantly higher than that of the healthy control （ P 〈 0.01 ） ; the plasma level of Hcy and hs-CRP in DN patients combined with cardio-cerebral vascular disease were significantly higher than that of DN patients free of heart and cerebrovascular diseases （ P 〈 0.01 ）. Hcy was positive correlated to Scr, TC, TG and hs-CRP （ P 〈 0.05 to P 〈 0. 01 ）. Conclusions： The level of Hcy is elevated in patients with DN; Hcy may participate in the genesis of heart and cerebrovascular disease in patients with DN ; the incidence of cardio-cerebral vascular diseases in DN patients may be reduced by lowering the plasma Hcy level.