糖耐量减低患者颈动脉内膜中层厚度与血同型半胱氨酸及超敏C-反应蛋白的关系

目的 观察糖耐量减低(IGT)患者的血同型半胱氨酸(Hcy)、超敏C-反应蛋白(hs-CRP)与颈动脉内膜中层厚度(IMT)的关系,以探讨其在并发动脉粥样硬化(AS)的临床意义.方法 选择IGT患者70例,根据颈动脉IMT,分为IMT正常组(IMT≤0.9 mm)、IMT增厚组(IMT>0.9 mm),分别进行血脂、hs-CRP、Hey及收缩压(SBP)、舒张压(DBP)、体重指数(BMI)等参数测定,并选择60名为健康对照组进行比较和相关性分析.结果 IMT增厚组hs-CRP、Hcy水平高于IMT正常组和正常对照组hs-CRP:(48.8±4.9)、(34.8±2.2)、(21.2±3.5)mg/L,P<0.05、P<0.01;HCY:(12.88±0.96)、(10.12±0.54)、(7.86±0.25)μmol/L,P<0.050.01],1GT者SBP、TG、TC及颈动脉IMT也均高于正常对照组(P均<0.05).颈动脉IMT与hs-CRP、Hcy、TC、SBP呈正相关(r值分别为0.616、0.557、0.351、0.252,P值分别为<0.01、<0.01、<0.05、<0.05).颈动脉IMT增厚组的Hcy水平与hs-CRP呈正相关(r=0.364,P<0.05).结论 IGT者颈动脉IMT较正常者已有所升高,已有早期的AS.而血Hcy和CRP对预测IGT者早期的AS有重要意义,高Hcy可能使CRP水平升高,进而引起早期的AS.

The relationship of high sensitive C-reative protein and homocysteine to carotic intimal-medial thickness in IGT patients

Objective To investigate the relationship of carotic intimal-medial thickness (IMT) to high sensitive C-reative protein (hs-CRP) and homocysteine (Hcy) in IGT patients. Methods Seventy patients with IGT were divided into two groups by carotic IMT levels: IMT normal group( IMT≤0.9 mm) and IMT increased group(IMT>0.9 mm). Sixty healthy people were chosen as controls. Blood-lipid, hs-CRP, Hcy, BMI, SBP and DBP were measured in all subjects. Results The Hcy and hs-CRP levels in IGT group were higher than those in controls (P<0.01) ,and also the carotic SBP,DBP,TG and TC levels were higher than those in controls(P<0.05). The Hcy and hs-CRP levels in carotic IMT increased group were higher than those in IMT normal group(P<0.05). The levels of the carotic IMT is positively correlated with hs-CRP(r=0.616, P<0.01), Hcy(r=0.557 ,P<0.01), TC (r=0.351,P<0.05), SBP(r=0.252, P<0.05). Hcy is positively correlated with hs-CRP in IMT increased group (r=0.364, P<0.05). Conclusions Compare with controls, the IMT was higher in IGT patients, and it had the early stage of atherosclerosis (AS). Hcy and hs-CRP levels may predict the early stage of AS in IGT. The high level of Hcy may increase the level of hs-CRP,then lead to the early stage of AS.