血清同型半胱氨酸与糖尿病合并颈动脉斑块形成的关系及预后研究
|
摘要
目的探讨血清同型半胱氨酸(Hey)与糖尿病合并颈动脉斑块形成的关系及预后。方法以我院2016年3月至2017年7月的172例2型糖尿病(T2DM)患者为研究对象,依据患者是否合并颈动脉斑块分为斑块组72和无斑块组100例,另以我院同期健康体检人群100例作为对照组。对比3组人群Hey、载脂蛋白A(APOA)、载脂蛋白B(APOB)、颈动脉斑块厚度(IMT)、三酰甘油(TG)、体质指数(BMI)等指标。结果斑块组患者血清Hcy、APOB、IMT、TG、BMI与无斑块组和对照组相比均明显升高,而APOA明显下降(P <0.05);血清Hey水平与IMT值、APOB、IMT、BMI、TG变化呈正相关,而与APOA值呈负相关(P<0.05);一年后,斑块组患者发生糖尿病下肢微血管病变、合并肾病、眼部病变发生率明显高于其他两组(P <0.05);血清Hey水平高者预后更差。结论血清Hey水平对T2DM合并颈动脉斑块的发生具有一定的辅助诊断价值,且对患者的不良预后具有一定的预测作用。
Objective To investigate the relationship between serum homocysteine(Hey) and patients with diabetes mellitus complicated with carotid plaque formation and its prognosis. Methods A total of 172 patients with diabetes mellitus(T2 DM) from March 2017 to July 2018 in our hospital were divided into the plaque group with 72 cases and the non-plaque group with 100 cases according to the presence or absence of carotid plaque. In the same period, 100 healthy people in the hospital were selected as the control group. The Hey,carotid plaque thickness(IMT),blood lipid levels,body mass index and several of indexes of the three groups were compared. Results Serum Hcy,APOB,IMT,BMI,and TG in the plaque group were significantly higher than those in the non-plaque group and the control group, while APOA was significantly decreased(P <0.05); Serum Hey level were positively correlated with IMT value, APOB, IMT, as well as the changes of BMI and TG,but negatively correlated with APOA(P <0.05). After one year of follow-up,the incidence of diabetic lower extremity microangiopathy, renal disease and ocular lesions were significantly higher in the plaque group than in the other two groups.(P < 0. 05); Patients with high serum Hey levels had a worse prognosis. Conclusion Serum Hey level has certain diagnostic value for the occurrence of T2DM complicated with carotid plaque, and it also has certain predictive effect on the poor prognosis of patients.
Objective To investigate the relationship between serum homocysteine(Hey) and patients with diabetes mellitus complicated with carotid plaque formation and its prognosis. Methods A total of 172 patients with diabetes mellitus(T2 DM) from March 2017 to July 2018 in our hospital were divided into the plaque group with 72 cases and the non-plaque group with 100 cases according to the presence or absence of carotid plaque. In the same period, 100 healthy people in the hospital were selected as the control group. The Hey,carotid plaque thickness(IMT),blood lipid levels,body mass index and several of indexes of the three groups were compared. Results Serum Hcy,APOB,IMT,BMI,and TG in the plaque group were significantly higher than those in the non-plaque group and the control group, while APOA was significantly decreased(P <0.05); Serum Hey level were positively correlated with IMT value, APOB, IMT, as well as the changes of BMI and TG,but negatively correlated with APOA(P <0.05). After one year of follow-up,the incidence of diabetic lower extremity microangiopathy, renal disease and ocular lesions were significantly higher in the plaque group than in the other two groups.(P < 0. 05); Patients with high serum Hey levels had a worse prognosis. Conclusion Serum Hey level has certain diagnostic value for the occurrence of T2DM complicated with carotid plaque, and it also has certain predictive effect on the poor prognosis of patients.
引文
[1]辛永飞,王珩.血清同型半胱氨酸与短暂性脑缺血发作及预后的相关性研究[J].中国中西医结合急救杂志,2016,23(2):172-174.
[2]张冬,张继明.血清同型半胱氨酸与2型糖尿病患者脑梗死相关性研究[J].天津医药,2016,44(7):902-905.
[3]高珊,李辉,张艳.2型糖尿病患者血同型半胱氨酸与颈动脉硬化的相关性分析[J].医学临床研究,2018,35(2):322-324.
[4]闫月月,岳淼.2型糖尿病患者促甲状腺激素同型半胱氨酸与颈动脉内中膜厚度的相关性[J].中国药物与临床,2017,17(2):249-251.
[5]蒋翔宁,陈俊峰,王家斌,等.Hcy、CRP及血清脂质检测对2型糖尿病患者的诊断及预后[J].检验医学与临床,2017,14(8):1126-1127.
[6]刘天城.维生素D和同型半胱氨酸与心血管疾病关系的研究进展[J].心血管病学进展,2017,38(5):612-616.
[7] PRF C,KINRA S,D'ALMEIDA V,et al. serum homocysteine and cysteine levels and anthropometric changes:a longitudinal study among brazilian children and adolescents[J]. J Am Col Nutr,2017,37(1):80-86.
[8]唐万富,程玉霞,吴文婷.同型半胱氨酸与心脑血管疾病转归的关系[J].中国医药导报,2017,14(8):68-70.
[9]贾卓鹏,金林,车红民.血浆同型半胱氨酸水平与脑静脉窦血栓形成及预后的关系[J].中华神经外科疾病研究杂志,2017,16(3):225-228.
[10] ZHONG C,XU T,XU T,et al. Plasma homocysteine and prognosis of acute ischemic stroke:a gender-specific analysis from CATIS randomized clinical trial.[J]. Mol Neurobiol, 2017, 54(3):2022-2030.
[11]高科,陶娟,范宁,等.联合检测三种生化指标对糖尿病肾病早期诊断的临床价值分析[J].现代检验医学杂志,2016,31(4):117-120.
[12] WANG C,GAO L,ZHANG Z G,et al. Procalcitonin is a stronger predictor of long-term functional outcome and mortality than highsensitivity c-reactive protein in patients with ischemic stroke[J].Mo Neurobiol,2016,53(3):1509-1517.
[13]唐钧,陈晶.同型半胱氨酸水平与心脑血管疾病发生的相关性研究[J].标记免疫分析与临床,2016,23(9):1052-1055.
[14] SHUANG C,GUO X,DONG S,et al. Relationship between lifestyle factors and hyperhomocysteinemia in general Chinese population:a cross-sectional study[J]. Postgrad Med,2016,129(2):216-223.
[2]张冬,张继明.血清同型半胱氨酸与2型糖尿病患者脑梗死相关性研究[J].天津医药,2016,44(7):902-905.
[3]高珊,李辉,张艳.2型糖尿病患者血同型半胱氨酸与颈动脉硬化的相关性分析[J].医学临床研究,2018,35(2):322-324.
[4]闫月月,岳淼.2型糖尿病患者促甲状腺激素同型半胱氨酸与颈动脉内中膜厚度的相关性[J].中国药物与临床,2017,17(2):249-251.
[5]蒋翔宁,陈俊峰,王家斌,等.Hcy、CRP及血清脂质检测对2型糖尿病患者的诊断及预后[J].检验医学与临床,2017,14(8):1126-1127.
[6]刘天城.维生素D和同型半胱氨酸与心血管疾病关系的研究进展[J].心血管病学进展,2017,38(5):612-616.
[7] PRF C,KINRA S,D'ALMEIDA V,et al. serum homocysteine and cysteine levels and anthropometric changes:a longitudinal study among brazilian children and adolescents[J]. J Am Col Nutr,2017,37(1):80-86.
[8]唐万富,程玉霞,吴文婷.同型半胱氨酸与心脑血管疾病转归的关系[J].中国医药导报,2017,14(8):68-70.
[9]贾卓鹏,金林,车红民.血浆同型半胱氨酸水平与脑静脉窦血栓形成及预后的关系[J].中华神经外科疾病研究杂志,2017,16(3):225-228.
[10] ZHONG C,XU T,XU T,et al. Plasma homocysteine and prognosis of acute ischemic stroke:a gender-specific analysis from CATIS randomized clinical trial.[J]. Mol Neurobiol, 2017, 54(3):2022-2030.
[11]高科,陶娟,范宁,等.联合检测三种生化指标对糖尿病肾病早期诊断的临床价值分析[J].现代检验医学杂志,2016,31(4):117-120.
[12] WANG C,GAO L,ZHANG Z G,et al. Procalcitonin is a stronger predictor of long-term functional outcome and mortality than highsensitivity c-reactive protein in patients with ischemic stroke[J].Mo Neurobiol,2016,53(3):1509-1517.
[13]唐钧,陈晶.同型半胱氨酸水平与心脑血管疾病发生的相关性研究[J].标记免疫分析与临床,2016,23(9):1052-1055.
[14] SHUANG C,GUO X,DONG S,et al. Relationship between lifestyle factors and hyperhomocysteinemia in general Chinese population:a cross-sectional study[J]. Postgrad Med,2016,129(2):216-223.