2型糖尿病患者血清高敏C反应蛋白、胱抑素C及同型半胱氨酸的表达及其临床意义

Expression and clinical significance of serum high-sensitivity C-reactive protein, cystatin C and homocysteine in type 2 diabetes patients

目的 探讨2型糖尿病患者血清高敏C反应蛋白、胱抑素C及同型半胱氨酸的表达及其临床意义。方法 2011年3月～2013年12月收入北京京煤集团总医院的120例2型糖尿病患者（糖尿病组）按是否合并糖尿病肾病分为单纯糖尿病组（56例）和糖尿病肾病组（64例）。选择同期110例健康体检者作为对照组。对研究对象行血清高敏C反应蛋白、胱抑素C及同型半胱氨酸的检测．并进行统计学分析。结果 糖尿病组血清高敏C反应蛋白、胱抑素C、同型半胱氨酸及血肌酐浓度分别为（3．56±1．45）mg／L、（1．05±0．23）mg／L、（17．79±2．35）μmol／L、（88．19±10．06）μmol／L，对照组分别为（1．06±0．28）mg／L、（0．76±0．36）mg／L、（8．89±2．35）μmol／L、（66．88±15．34）μmol／L，两组比较差异均有统计学意义（P〈0．05）。单纯糖尿病组患者血清高敏C反应蛋白、胱抑素C、同型半胱氨酸及血肌酐浓度分别为（2．50±1．64）mg／L、（0．85±0．23）mg／L、（15．70±4．05）μmol／L、（65．19±10．06）μmol／L，糖尿病肾病组分别为（7．35±4．34）mg／L、（2．49±0．36）mg／L、（20．20±8．05）μmol／L、（150．30±30．23）μmol／L，两组比较差异均有统计学意义（P〈0．05）。糖尿病患者血浆同型半胱氨酸与血肌酐、高敏C反应蛋白、胱抑素C均呈正相关（r=0．605、0．840、0．601，P〈0．05）；高敏C反应蛋白与血肌酐、胱抑素C呈正相关（r=0．521、0．672，P〈0．05）；血肌酐与胱抑素C呈正相关（r=0．593，P〈0．05）。结论 2型糖尿病患者血清高敏C反应蛋白、血清胱抑素C及血浆同型半胱氨酸能反映糖尿病患者早期的肾损害，为临床判定糖尿病肾病比较敏感的指标，可为临床对糖尿病肾病的早期诊断提供帮助。

Objective To probe the expression and clinical significance of the serum high-sensitivity C-reactive protein, cystatin C and homocysteine in type 2 diabetes patients. Methods From March 2011 to December 2013, 120 patients with type 2 diabetes （diabetes group） treated in Beijing Jingmei Group General Hospital, were divided into simple diabetes group （56 cases） and diabetes nephropathy group （64 cases） according to whether diabetes nephropathy or not. At the same time, 110 cases of healthy people who took the health examination were selected as control group. All the research objects were given the serum high sensitivity C-reactive protein, cystatin C and homocysteine test, and the data were statistically analyzed. Results The levels of serum high-sensitivity C-reactive protein, cystatin C, homocysteine and serum creatinine concentration in diabetes group were （3.56±1.45） mg/L, （1.05±0.23） mg/L, （17.79±2.35） μmol/L, （88.19±10.06）μmol/L, those in control group were （1.06±0.28） mg/L, （0.76±0.36） μg/L, （8.89±2.35） μmol/L, （66.88±15.34） μmol/L, the differences were statistically significant （P 〈 0.05）. The levels of serum high-sensitivity C- reactive protein, cystatin C, homocysteine and serum creatinine concentration in simple diabetes were （2.50±1.64） mg/L, （0.85±0.23） mg/L, （15.70±4.05） μmol/L, （65.19±10.06） μmol/L, those in diabetes nephropathy group were （7.35±4.34） mg/L, （2.49±0.36） mg/L, （20.20±8.05） μmol/L, （150.30±30.23） μmol/L, the differences were statistically significant （P 〈 0.05）. The plasma homocysteine （Hcy） of the diabetess was positively correlated with serum creatinine, hs-CRP, cystatin C （r = 0.605, 0.840, 0.601, P 〈 0.05）, hs-CRP was positively correlated with serum creatinine, cystatin C （r = 0.521, 0.672, P 〈 0.05）, serum creatinine was positively correlated with cystatin C （r = 0.593, P 〈 0.05）. Conclusion Serum high-sensitivity C-reactive protein, serum cystatin C and plasma homocysteine of the type 2 diabetes can reflect early diabetes kidney damage, clinical judgment more sensitive indicator of diabetes nephropathy,it is helpful to early clinical judgment of diabetes nephropathy.