2型糖尿病微血管病变患者血浆同型半胱氨酸检测及其意义

目的检测2型糖尿病微血管病变(DMAP)患者血浆同型半胱氨酸(HCY)水平并探讨其临床意义。方法152例2型糖尿病患者根据微血管并发症发生情况分为无微血管并发症(NDC)组、糖尿病视网膜病变(DR)组和糖尿病肾病(DN)组,用酶联免疫吸附试验分别检测各组患者血浆HCY水平,并同步测定可溶性血栓调节蛋白(sTM)、叶酸(FA)和维生素B12(VitB12)含量,与32名正常对照者进行比较。结果糖尿病各组血HCY、sTM水平均明显高于正常对照组(P<0.05),DMAP组(DR组和DN组)又高于NDC组(P<0.05),而FA、VitB12水平与对照组相比均显著降低(P<0.05)。相关分析表明,糖尿病患者HCY水平与sTM水平呈正相关(P<0.01),与FA、VitB12水平呈负相关(P<0.01)。结论高HCY血症是DMAP的重要危险因素,测定糖尿病患者血浆HCY水平有助于监测、判断DMAP的发生发展。

Determination of the plasma homocysteine in type 2 diabetes with microangiopathy and its significance

Objective To determine the levels of plasma homocysteine(HCY) in type 2 diabetes with microangiopathy(DMAP) and evaluate its clinical significance. Methods 152 cases of type 2 diabetes mellitus patients were divided into three groups according to vessel lesions:no-diabetic complication group(NDC), diabetic retinopathy group(DR) and diabetic nephropathy group(DN). 32 normal persons were regarded as control group. Levels of HCY were measured by enzyme linked immunosorbent assay. The plasma soluble thrombomodulin(sTM), folate(FA) and vitamin B_(12)(VitB_(12) were determined simultaneously. Results The levels of HCY and sTM in patients with type 2 diabetes mellitus were significantly higher than control group(P<(0.05) and the levels of FA and VitB_(12) were lower than control group(P<(0.05). The levels of HCY and sTM in DMAP (DR and DN) were significantly higher than those without microangiopathy (P<(0.05). Correlation analysis of results showed that the plasma HCY level in type 2 diabetes was positively related to sTM (P<(0.01) and negatively related to plasma FA and VitB_(12) levels(P<(0.01). Conclusions The hyperhomocysteinemia is an important risk factor of DMAP. The determination of the plasma HCY level could be beneficial to clinical evaluation of the occurrence and development of DMAP.