血浆心钠素、脑利钠肽、C型利钠肽在老年2型糖尿病合并血管病变患者中的变化及临床意义

The changes and clinical significance of ANP,BNP and CNP in type 2 diabetes with angiopathy

目的探讨血浆心钠素(ANP)、脑利钠肽(BNP)、C型利钠肽(CNP)水平在老年T2DM合并血管病变患者中的变化及意义。方法选取老年T2DM患者120例,根据是否合并血管病变分为合并血管病变组44例和单纯T2DM组76例,另选取同期健康体检者60名作为对照(NC)组,检测3组血糖、血脂、ANP、BNP、CNP及血小板内皮细胞黏附因子-1(PECAM-1)等指标,并进行分析。结果血管病变组ANP[(3.59±1.72)vs(2.39±1.04)vs(2.70±1.58)nmol/L]、BNP[(0.39±0.10)vs(0.26±0.08)vs(0.23±0.09)nmol/L]、PECAM-1[(6.98±1.30)vs(3.29±1.04)vs(4.61±1.17)μg/L]高于NC组和单纯T2DM组(P<0.05);CNP[(2.20±1.18)vs(3.37±1.27)vs(4.29±1.09)nmol/L]低于NC组和单纯T2DM组(P<0.05)。多元线性回归显示,ANP、BNP与PECAM-1呈正相关,CNP与PECAM-1呈负相关(P<0.05)。结论 ANP、BNP、CNP在老年T2DM血管病变患者水平发生变化,其可作为诊断T2DM患者血管病变的指标。

Objective To explore the changes and clinical significance of plasma atrial natriuretic peptide（ANP）,brain natriuretic peptide（BNP） and C-type natriuretic peptide（CNP） levels in type 2diabetes mellitus（T2DM） with vascular lesions.Methods 120 cases of T2 DM elders were divided into group with vascular disease（n = 44） and group without vascular disease（n = 76）.60 cases of healthy subjects were set as control group.The levels of glucose,lipid,ANP,BNP,CNP and platelet endothelial cell adhesion molecule-1（PECAM-1） were measured and analyzed.Results The levels of ANP[（3.59 ±1.72） vs（2.39±1.04） vs（2.70±1.58） nmol/L],BNP[（0.39 ± 0.10） to（0.26 ± 0.08） vs（0.23 ±0.09） nmol/L]and PECAM-1[（6.98±1.30） vs（3.29 ± 1.04） vs（4.61±1.17） μg/L]in vascular group were higher than that in control group and simple T2 DM group（P〈0.05）;the levels of CNP[（2.20 ＋1.18） to（3.37 ± 1.27） vs（4.29 ± 1.09） nmol/L]in vascular group were lower（P〈0.05）.Multiple linear regression analysis showed that ANP and BNP were positively correlated with PECAM-1,and CNP was negatively correlated with PECAM-1（P〈0.05）.Conclusion The changes of ANP,BNP and CNP indicate that these indicators can be used as biomarkers of T2 DM patients with vascular disease.