论文部分内容阅读
目的探讨马来酸桂哌齐特对2型糖尿病肾病(DN)患者血浆同型半胱氨酸(Hcy)的影响,阐明Hcy变化在2型DN发生发展中的作用机制。方法选取初诊2型糖尿病(T2DM)患者90例,根据24h尿微量白蛋白(UmAlb)的量将其分为2组:单纯糖尿病组42例(UmAlb<30mg/24h)和早期DN组48例(UmAlb30～300mg/24h)。同期选择我院健康体检者37名作为健康对照组(NC组),用酶联免疫吸附试验(ELISA)法检测各组空腹血浆Hcy浓度,同时测定各组的体质量指数、血压、血糖、血脂、超敏C反应蛋白(hs-CRP)、颈动脉内膜中层厚度(IMT)、UmAlb等指标,并分析血浆Hcy与各指标间的相关性。结果 T2DM组和DN组患者的Hcy均明显高于NC组[(19.8±4.8)、(14.2±3.4)和(9.8±2.5)μmol/L,P<0.05或P<0.01];DN组患者的Hcy均明显高于T2DM组[(19.8±4.8)和(14.2±3.4)μmol/L,P<0.05]。DN组血浆Hcy与hs-CRP、空腹血糖(FBG)、IMT、24hUmAlb呈正相关,与HDL-C呈负相关(P<0.05或P<0.01)。DN患者血浆Hcy水平降低的程度与IMT降低程度明显相关(r=0.395,P<0.05)。IMT、hs-CRP和24hUmAlb是影响DN组患者Hcy水平的独立危险因素。结论 DN患者血浆Hcy水平增高,且与炎症反应及动脉粥样硬化(AS)具有一定的相关性。马来酸桂哌齐特可改善炎症反应、AS及肾功能,同时降低血浆Hcy水平。
Objective To investigate the effect of cinepazide maleate on plasma homocysteine (Hcy) in patients with type 2 diabetic nephropathy (DN) and to elucidate the mechanism of Hcy changes in the development of type 2 DN. Methods Totally 90 patients with newly diagnosed type 2 diabetes mellitus (T2DM) were enrolled in this study. They were divided into 2 groups according to the amount of urinary albumin (UmAlb): 42 in the simple diabetic group (UmAlb <30mg / 24h) and 48 in the early DN group UmAlb30 ~ 300mg / 24h). In the same period, 37 healthy volunteers in our hospital were selected as healthy control group (NC group). The fasting plasma Hcy levels in each group were measured by enzyme-linked immunosorbent assay (ELISA), and body mass index, blood pressure, blood glucose, , Hs-CRP, IMT, UmAlb and other indicators, and analysis of plasma Hcy and the correlation between the indicators. Results The Hcy in T2DM group and DN group was significantly higher than that in NC group [(19.8 ± 4.8), (14.2 ± 3.4) and (9.8 ± 2.5) μmol / L, P <0.05 or P <0.01] Hcy were significantly higher than those in T2DM group [(19.8 ± 4.8) vs (14.2 ± 3.4) μmol / L, P <0.05]. The plasma Hcy in DN group was positively correlated with hs-CRP, fasting blood glucose (FBG), IMT, 24hUmAlb, and negatively correlated with HDL-C (P <0.05 or P <0.01). The degree of plasma Hcy level in patients with DN was significantly correlated with the decrease of IMT (r = 0.395, P <0.05). IMT, hs-CRP and 24hUmAlb are independent risk factors affecting the level of Hcy in DN patients. Conclusions The plasma Hcy levels in DN patients are elevated, and have some correlation with inflammatory reaction and atherosclerosis (AS). Cinepazide maleate can improve inflammation, AS and renal function, while reducing plasma Hcy levels.