2型糖尿病合并肾脏病变患者血清SOD、SA、HCY、CysC的变化规律及临床意义

Changes of Serum SOD,SA,HCY and CysC in Type 2 Diabetic Patients with Renal Disease and Its Clinical Significance

目的分析2型糖尿病患者合并肾脏病变时生化、血常规等指标的变化情况,研究血清唾液酸(SA)、超氧化物岐化酶(SOD)、同型半胱氨酸(HCY)、胱抑素C(CysC)等指标与2型糖尿病合并肾脏病变发展过程中的变化规律及临床意义。方法收集2013年7月至2014年7月在解放军总医院住院的2型糖尿病患者449例,根据尿微量白蛋白/肌酐比值(ACR)进行分组并收集同时期在我院进行健康体检的正常人群73例,对上述指标进行统计学分析。结果(1)疾病组与正常组比较SA水平显著升高、SOD水平显著降低,而两组间CysC、HCY差异不具有统计学意义。(2)ACR≤30组与30<ACR<300组比较血清SOD、HCY、CysC水平差异具有统计学意义,SA差异无统计学意义;30<ACR<300组与ACR≥300组比较CysC,SA、SOD水平差异具有统计学意义,HCY差异无统计学意义;ACR≤30组与ACR≥300组比较SOD、SA、HCY、CysC差异均具有统计学意义;(3)疾病组年龄≤45岁、45~60岁以及≥60岁三组间CysC、HCY、SOD水平差异具有统计学差异,SA水平差异无统计学意义,对照组不同年龄段间指标比较,各水平差异均无统计学意义。结论在2型糖尿病合并肾脏病变的患者中,随着病情的不断发展,SA、HCY、CysC水平逐渐升高,SOD水平不断下降。因此2型糖尿病合并肾脏病患者血清SA、SOD、HCY、CysC的水平出现变化时,提示其病情的严重程度出现相应的改变。

Objective To analyze the changes of biochemical and blood routine indexes in patients with type II diabetes mellitus(T2DM)complicated with renal disease,and to study the associations between SA,SOD,HCY and CysC and the development of T2DM complicated with renal disease,so to explore the significance and value of these indexes in the clinical treatment.Methods A total of 449 patients with T2DM who were hospitalized in the PLA general hospital from July,2013 to July,2014 and 73 normal people who underwent physical examination in the hospital during the same period were collected for the study.A series of indicators were analyzed among this cohort.Results(1)Compared with the normal group,the level of SA was significantly increased and the level of SOD was significantly decreased,while the difference of CysC and HCY between the two groups was not statistically significant.(2)The CysC,HCY and SOD levels of the ACR≤30 and 30<ACR<300 group were significantly different,but the level of SA was not significant.Compared with CysC,SA and SOD levels in group ACR≥300 and group ACR<300,there were significant differences,but HCY was not significantly different.There were significant differences for all four markers between the ACR≤30 group and ACR≥300 group.(3)In the disease group,there were statistically significant differences in CysC,HCY and SOD levels among the groups of≤45,45-60 and≥60.There were no statistically significant differences in SA levels among these three groups.There was no statistical difference among the three normal groups.Conclusion In patients with type 2 diabetes complicated with renal disease,with the continuous development of the disease,the concentrations of SA,HCY and CysC gradually increase,while the concentration of SOD continuously decreases.Therefore,when there are changes of the serum concentrations of SA,SOD,HCY and CysC in patients with type 2 diabetes mellitus combined with renal disease,the severity of the disease changes accordingly.