HbA1cCys―CHcy水平与糖尿病患者肾脏功能损害相关性研究.docVIP

HbA1cCys―CHcy水平与糖尿病患者肾脏功能损害相关性研究 　　【摘要】 目的：探讨全血糖化血红蛋白（HbA1c）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（UAER300 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HbA1c、Cys-C、Hcy水平，估算肾小球滤过率（eGFR），并进行组间比较，采用Pearson相关分析探讨全血HbA1c及血清Cys-C、Hcy水平与eGFR的关系。结果：HbA1c、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eGFR依次降低，组间差异均有统计学意义（P0.05）；Pearson相关分析显示，HbA1c、Cys-C、Hcy水平与eGFR呈明显负相关（r=-0.152、-0.116、-0.237，P0.05）；ROC曲线分析显示，以HbA1c、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HbA1c、Cys-C、Hcy单项检测。结论：糖尿病患者全血HbA1c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。 　　【关键词】 糖尿病肾病； 糖化血红蛋白； 胱抑素C； 同型半胱氨酸； 诊断 　　【Abstract】 Objective：To discuss the correlation of glucose hemoglobin （HbA1c） 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 （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 HbA1c and Cys-C，Hcy were detected，and the rate of glomerular filtration （eGFR） were estimated.The relationship of HbA1c，Cys-C，Hcy levels and eGFR were analyzed by Pearson correlation analysis.Result：There were statistically significant difference between the four groups on the levels of HbA1c，Cys-C，Hcy，eGFR （P0.05）.Pearson correlation analysis showed that，HbA1c，Cys-C，Hcy levels was negatively correlated with eGFR （r=-0.152，-0.116，-0.237，P0.05）.ROC curve analysis showed that，the area under the curve （AUC） of HbA1c，Cys-C，Hcy were significantly greater than HbA1c，Cys-C，Hcy single detection on the diagnosis of early renal damage in type 2 diabetic patients.Conclusion：The levels of whole blood HbA1c and serum Cys-C，Hcy of patients with type 2 diabetes increase，with