2型糖尿病合并高尿酸血症患者尿微量白蛋白、血超敏C反应蛋白和血液流变学检测及其临床意义

Detection of Urine Microalbumin,Blood Hypersensitive C-Reactive Protein and Hemorheology and Their Clinical Significances in Type 2 Diabetic Patients with Hyperuricemia

目的检测2型糖尿病合并高尿酸血症患者尿微量白蛋白(MAU)、血超敏C反应蛋白(hs-CRP)和血液流变学指标,探讨其临床意义。方法对2型糖尿病合并高尿酸血症患者(HUA组)、2型糖尿病尿酸正常患者(NUA组)及健康体检者(对照组)各120例进行MAU、hs-CRP和血液流变学指标(全血黏度低切、全血黏度中切、全血黏度高切、血浆黏度、红细胞比积、纤维蛋白原、血沉、红细胞变形指数、红细胞聚集指数、红细胞刚性指数)检测。结果 HUA组与NUA组的代谢综合征(MS)患病率分别为30.0%(36/120)与15.0%(18/120),2组比较差异有统计学意义(χ2=4.69,P<0.05)。根据MS诊断标准,HUA组合并1、2种代谢异常率低于NUA组,合并3、4种代谢异常率高于NUA组(P<0.05)。HUA组及NUA组的MAU、hs-CRP水平均显著高于对照组,HUA组高于NUA组(P<0.01或P<0.05)。HUA组、NUA组血液流变学各项指标均高于对照组(均P<0.01);HUA组的全血黏度(低切、中切、高切)、血浆黏度、红细胞变形指数、红细胞聚集指数及红细胞刚性指数均高于NUA组(P<0.05),2组血沉、红细胞压积和纤维蛋白原比较差异无统计学意义(P>0.05)。结论 MAU、hs-CRP和血液流变学指标检测对2型糖尿病合并高尿酸血症患者有一定的临床意义。

ABSTRACT:Objective To detect urinary microalbumin (MAU)levels,blood hypersensitive C-reactive protein (hs-CRP)levels and hemodynamic indexes in type 2 diabetic patients with hype-ruricemia,and to explore their clinical significances.Methods The urinary MAU levels,blood hs-CRP levels and hemodynamic indexes (whole blood viscosity at low,medium and high shear rates,plasma viscosity,hematocrit,fibrinogen,erythrocyte sedimentation rate,erythrocyte de-formation index,erythrocyte aggregation index,erythrocyte rigidity index,etc.)were measured in 120 type 2 diabetic patients with hyperuricemia (HUA group),120 type 2 diabetic patients with normal uric acid levels (NUA group ) and 120 healthy subjects (control group ).Results The incidence of metabolic syndrome (MS)in HUA group (30.0%,36/120)was significantly&nbsp;higher than that in NUA group (15.0%,18/120)(χ2 =4.69,P <0.05).According to the criteria for the diagnosis of MS,the proportion of patients with 1 or 2 types of metabolic abnormalities in HUA was lower than that in NUA group,but the proportion of patients with 3 or 4 types of met-abolic abnormalities in HUA was higher than that in NUA group (P <0.05).The levels of urina-ry MAU and blood hs-CRP in NUA group were higher than those in control group,but were low-er than those in HUA group (P <0.01 or P <0.05).All hemodynamic indexes in control group were lower than those in HUA group or NUA group (P <0.01).Whole blood viscosity at low, medium and high shear rates,plasma viscosity,erythrocyte deformation index,erythrocyte aggre-gation index,and erythrocyte rigidity index in HUA group were higher than those in NUA group (P <0.05).However,no significant differences in erythrocyte sedimentation rate,fibrinogen and hematocrit were found between the two groups (P >0.05).Conclusion The detection of urinary MAU levels,blood hs-CRP levels and hemodynamic indexes is of great significance in type 2 dia-betic patients with hyperuricemia.