糖尿病血清同型半胱氨酸测定的临床意义

Clinical significance of determination of serum homocysteine in patients with diabetes mellitus

目的 :探讨 2型糖尿病患者高同型半胱氨酸 (Hcy)与心脑血管病及肾病的关系。方法 :比较 132例糖尿病 (单纯 2型糖尿病、糖尿病合并心脑血管病及肾病 )患者与正常人群血清 Hcy的水平 ,并观察叶酸对其治疗的效果。结果 :单纯 2型糖尿病组、糖尿病合并冠心病组、糖尿病合并脑梗死组及糖尿病合并肾病组的血清Hcy水平均明显高于对照组 (P均 <0 .0 0 1) ;糖尿病合并冠心病组、糖尿病合并脑梗死组及糖尿病合并肾病组的血清 Hcy水平也均明显高于单纯 2型糖尿病组 (P均 <0 .0 0 1) ;单纯冠心病或单纯脑梗死组血清 Hcy水平均高于单纯 2型糖尿病组 (P均 <0 .0 0 1)。糖尿病合并冠心病及糖尿病合并脑梗死组与单纯冠心病及脑梗死组比较均有显著性差异 (P均 <0 .0 0 1)。应用叶酸治疗 ,高 Hcy水平明显下降 (P<0 .0 0 1)。结论 :高 Hcy是 2型糖尿病合并心脑血管病及肾病的危险因素 ,小剂量叶酸对治疗高 Hcy血症有效。

Objective:To investigate the relationship between homocysteine (Hcy) and cardiocerebral vascular disease and nephropathy in type 2 diabetes mellitus patients.Methods:The serum levels of Hcy of 132 patients with type 2 DM (type 2 DM without complications and DM with cardiocerebral vascular disease ,DM with nephropathy) and normal people were compared.The treatment effect of folic acid on hyper homocys teinemia was observed.Results:The levels of Hcy in simple DM group,DM with coronary heart disease (CHD) group,DM with cerebral infarction group and DM with nephropathy group were higher than that in control group (all P <0 001).Hcy levels in DM with CHD or DM with cerebral infarction or DM with nephropathy groups were higher than that in simple DM group (all P <0 001).The levels of Hcy in simple CHD or cerebral infarction without DM was higher than simple DM (all P <0 001).There were significant differences of Hcy levels between DM with CHD or DM with cerebral infarction and simple CHD or simple cerebral infarction group (all P <0 001).The level of Hcy was reduced significantly after treatment with folic acid( P <0 001).Conclusions:Hyperhomocysteinemia is a risk factor for DM with cardiocerebral vascular disease and nephropathy.Lowdose of folic acid is effective in the treatment of hyperhomocysteinemia.