高同型半胱氨酸血症与2型糖尿病乳酸酸中毒关系的探讨

目的探讨高同型半胱氨酸血症与2型糖尿病(T2DM)乳酸酸中毒的关系。方法选取100例T2DM患者,其中60例服用双胍类降糖药物(A组),40例未服用双胍类降糖药物(B组),另择100例健康人作为对照组。抽血检测各组的血乳酸、糖化血红蛋白(HbA1c)、肌酐(Cr)、尿素氮(BUN)和同型半胱氨酸(Hcy)。结果 A组的乳酸水平为(25.12±5.09)mmol/L,而B组为(2.10±0.20)mmol/L,对照组的乳酸水平为(1.15±0.10)mmol/L,三组比较差异有统计学意义(F=1519.12,P=0.0000),进一步两两比较,A组的乳酸水平显著高于B组和对照组(均P<0.01),而B组乳酸水平和对照组比较差异无统计学意义(P>0.05)。三组Cr、BUN、Hcy和HbA1c的检测值比较差异均有统计学意义(P<0.01),其中A组、B组的Cr、BUN、Hcy和HbA1c检测值均显著高于对照组(P<0.01),A组的Cr、BUN和Hcy检测值显著高于B组(P<0.01)。Hcy与血乳酸水平呈正相关(r=0.997,P<0.01)。结论高同型半胱氨酸血症是2型糖尿病乳酸酸中毒的一个重要危险因素。

Discussion on the relationship of Hyperhomocysteinemia and type-2 diabetic mellitus lactic acidosis

Objective To explore the relationship of Hyperhomocysteinemia and type-2 diabetic mellitus(T2DM) lactic acidosis.Methods 100 cases with T2DM were divided into Group A(60 cases) and Group B(40 cases).Group A took Metformin for oral administration and Group B took no Metformin.100 healthy people were selected as the control group.The lactic acid of artery blood,HbA1c,Hcy,BUN and Cr of each group were detected after blood drawing.Results The lactic acid value of Group A,Group B,the control group were respectively(25.12±5.09) mmol/L,(2.10±0.20)mmol/L and(1.15±0.10)mmol/L.Their difference had statistical significance(F=1519.12,P=0.0000).Further comparison showed that the level of lactic acid of Group A was significantly higher than those of Group B and the control group(P<0.01).There was no significant difference in the lactic acid level of Group B and the control group(P>0.05).The difference of Cr,Hcy,BUN and HbA1c values was significant among the three groups(P<0.01).The Cr,Hcy,BUN and HbA1c values of Group A and Group B were significantly higher than those of the control group(P<0.01).The Cr,Hcy,BUN values of Group A were much higher than those of Group B.Levels of Hcy and lactate had significant positive relevance(r=0.997,P<0.01).Conclusion Hyperhomocysteinemia is an independent risk factor in T2DM lactic acidosis.