血清同型半胱氨酸测定在糖尿病肾病中的临床意义

目的 探讨分析糖尿病肾病中血清同型半胱氨酸（Hcy）的变化和其炎症因子的相关性。 方法 选取2012年2月~2016年8月于我院就诊的2型糖尿病肾病患者共160例，根据尿白蛋白排泄率和血肌酐水平分为单纯糖尿病组（DM组）、早期糖尿病肾病组（EDN组）、糖尿病肾病组（CDN组）和肾功能衰竭组（CRF组），以40例健康体检者作为对照组，比较各组患者的Hcy值及生化指标，分析Hcy其糖尿病肾病患者炎症因子IL-1、IL-6、TNF-α和hsCRP的相关性。 结果 5组患者比较，其GLU、HbA1c、UREA、Cr、TP、ALB、TCH和TG差异均有统计学意义（P<0.01）；Hcy差异有统计学意义（F=27.452，P<0.01）；hsCRP、TNF-α、IL-1和IL-6差异有统计学意义（P<0.01）；血清Hcy水平和hsCRP存在显著的正相关（r=0.624，P<0.01）、和TNF-α存在正相关（r=0.557，P<0.01）、和IL-1存在显著正相关（r=0.568，P<0.01）、和IL-6存在显著正相关（r=0. 417，P=0.017）。 结论 Hcy在糖尿病肾病中病情进展中具有重要作用，可作为糖尿病肾病患者肾血管损伤及病情进展评价的重要指标，且与hsCRP、IL-1、IL-6和TNF-α具有显著的相关性。  

Clinical significance of serum homocysteine detection in diabetic nephropathy

Objective To study the serum homocysteine (Hcy) level in diabetic nephropathy patients and the its correlation of the inflammatory factors. Methods From February 2012 to August 2012, a total of 160 patients with type 2 diabetic nephropathy were selected in our hospital, according to the urinary albumin excretion rate and serum creatinine level, which is divided into diabetes mellitus group (DM group), early diabetic nephropathy (EDN) group, diabetic nephropathy group (CDN) and renal failure (CRF) group, 40 cases of healthy physical examination as the control group, comparing the patients’ Hcy level and their biochemical index in the five group patients, to analyze the correlation between the Hcy level and the inflammatory factor, such as IL-6, IL-1 TNF-α and hsCRP. Results GLU、HbA1c、UREA、Cr、TP、ALB、TCH and TG in the five group patients had no significant difference (P<0.01), the five patients of Hcy comparative differences were statistically significant (F=27.452,P<0.01), the inflammation indicator in the five patients, including hsCRP, TNF-α, IL-1 and IL-6 comparison had significant difference (P<0.01), the serum Hcy levels had significant positive correlation with hsCRP (r=0.624, P<0.01), the serum Hcy levels had significant positive correlation with TNF-α (r=0.557, P<0.01), the serum Hcy levels had significant positive correlation with IL-1 (r=0.568, P<0.01), serum Hcy levels had significant positive correlation with IL-6 (r=0. 417, P=0.017). Conclusion Hcy plays a great important role in the progression of diabetic nephropathy, it can be used as the important indexes for evaluation of renal vascular injury and disease progression in DN patients, and has significant positive correlation with hsCRP, IL-1, IL 6 and TNF-α.