血清脂蛋白a与同型半胱氨酸在糖尿病高血压的临床应用

Clinical application of serum lipoprotein a and homocysteine in diabetic patients with hypertension

目的探讨糖尿病高血压患者血清脂蛋白a[LP(a)]与同型半胱氨酸(HCY)的水平变化,寻找其相关性。方法收集300例身体健康体检人群(对照组)和269例糖尿病高血压患者血清LP(a)和HCY检测值,进行回顾性统计分析。结果糖尿病高血压组与对照组LP(a)值分别为(474.36±65.53)mg/L、(146.11±21.94)mg/L,差异显著(P<0.005);糖尿病高血压组和对照组HCY值分别为(34.82±5.91)umol/L、(12.09±4.18)umol/L,差异显著(P<0.005)。糖尿病高血压患者LP(a)、HCY阳性率比较,不存在相关性(x2=25.09,r=0.2110,P<0.005)。糖尿病高血压患者LP(a)和HCY阳性率分别为49.07%和42.37%,二者联合检测的阳性率为61.34%,明显高于单个指标的阳性率(P<0.05)。结论糖尿病高血压患者血清LP(a)和HCY有较高临床诊断价值,二者没有相关性,联合检测可提高临床对糖尿病高血压疾病的诊断。

Objective To investigate the changes of serum lipoprotein LP（a） and homocysteine（HCY） levels in patients with diabetes and hypertension, and to find the correlation between them. Methods The serum LP（a） and HCY among 300 normal people（control group） and 269 diabetic patients with hypertension were collected and analyzed retrospectively. Results LP（a） in the Group with diabetes hypertension and control group were（474.36 ＋ 65.53） mg/L and（146.11 ＋ 21.94） mg/L respectively, and the difference was significant（P〈0.005）; HCY in group with diabetic hypertension and control group were（34.82 ＋ 5.91） umol/L,（12.09 ＋ 4.18） umol/L respectively, the difference was significant too（P〈0.005）. In patients with hypertension and diabetes mellitus, LP（a） and HCY positive rates were 49.07%and 42.37%, there was no correlation between LP（a） level and HCY level（x2=25.09, r=0.2110, P〈0.005）. The positive rate was 61.34 % if LP（a） level and HCY were detected together, which was significantly higher than that when only one index was detected（P〈0.05）.Conclusion The serum levels of LP（a） and HCY in patients with diabetic hypertension have high clinical diagnostic value, the two indexes are not related, combined detection can improve the clinical diagnosis of diabetic hypertension.