摘要
目的：探讨全血糖化血红蛋白（Hb A1c）及血清胱抑素C（Cys-C）、同型半胱氨酸（Hcy）水平与糖尿病患者肾脏功能损害的相关性。方法：选取2014年7月-2015年8月本院收治的2型糖尿病患者181例作为观察组,根据尿蛋白排泄率（UAER）分为三组,分别为正常蛋白尿组（UAER〈30 mg/24 h,n=53）、微量蛋白尿组（UAER 30~300 mg/24 h,n=70）、临床蛋白尿组（UAER〉300 mg/24 h,n=58）,另选取同期在本院体检的健康志愿者60例作为对照组。所有患者及健康体检者均测量全血Hb A1c、Cys-C、Hcy水平,估算肾小球滤过率（e GFR）,并进行组间比较,采用Pearson相关分析探讨全血Hb A1c及血清Cys-C、Hcy水平与e GFR的关系。结果：Hb A1c、Cys-C、Hcy水平在对照组、正常蛋白尿组、微量蛋白尿组、临床蛋白尿组中依次升高,而e GFR依次降低,组间差异均有统计学意义（P〈0.05）;Pearson相关分析显示,Hb A1c、Cys-C、Hcy水平与e GFR呈明显负相关（r=-0.152、-0.116、-0.237,P〈0.05）;ROC曲线分析显示,以Hb A1c、Cys-C、Hcy联合检测诊断2型糖尿病患者早期肾损伤的曲线下面积（AUC）明显大于Hb A1c、Cys-C、Hcy单项检测。结论：糖尿病患者全血Hb A1c及血清Cys-C、Hcy水平升高,对糖尿病患者早期肾脏功能损害诊治具有一定的参考价值。
Objective：To discuss the correlation of glucose hemoglobin（Hb A1c） and serum cystatin C（Cys-C）,homocysteine（Hcy）levels and renal damage on patients with type 2 diabetes diabetic.Method：A total of 181 patients with type 2 diabetes in our hospital between July 2014 to August 2015 were selected and divided into three groups according to the rate of urinary albumin excretion（UAER）,normal albuminuria group（UAER30 mg/24 h,n=53）,microalbuminuria（UAER 30-300 mg/24 h,n=70）,clinical albuminuria group（UAER300 mg/24 h,n=58） respectively, and 60 cases of healthy volunteers at the same period were selected as control group.The levels of whole blood Hb A1 c and Cys-C,Hcy were detected,and the rate of glomerular filtration（e GFR） were estimated.The relationship of Hb A1 c,Cys-C,Hcy levels and e GFR were analyzed by Pearson correlation analysis.Result：There were statistically significant difference between the four groups on the levels of Hb A1 c,Cys-C,Hcy,e GFR（P〈0.05）.Pearson correlation analysis showed that,Hb A1 c,Cys-C,Hcy levels was negatively correlated with e GFR（r=-0.152,-0.116,-0.237,P〈0.05）.ROC curve analysis showed that,the area under the curve（AUC） of Hb A1 c,Cys-C,Hcy were significantly greater than Hb A1 c,Cys-C,Hcy single detection on the diagnosis of early renal damage in type 2 diabetic patients.Conclusion：The levels of whole blood Hb A1 c and serum Cys-C,Hcy of patients with type 2 diabetes increase,with some reference value for early diagnosis and treatment of renal damage in diabetic patients.
出处
《中国医学创新》
CAS
2016年第11期41-44,共4页
Medical Innovation of China
基金
惠州市科技计划项目(2015Y034)
作者简介
通信作者：林彩凤
