糖尿病肾病患者糖化血红蛋白、胱抑素C及血脂水平调查研究

【目的】探讨2型糖尿病肾病（diabetic nephropathy,DN）患者糖化血红蛋白（glycosylated hemoglobin,HbA1c）、血清胱抑素C（cystatin C,CysC）及血脂水平的变化及其临床意义。【方法】根据患者24 h尿微量白蛋白排泄率（urinary albumin excretion rate,UAER）,将100例2型糖尿病（type 2 diabetes mellitus,T2DM）患者分为3组：单纯糖尿病组、糖尿病肾病早期组、糖尿病肾病中晚期组,并选取健康志愿者30例作为对照组。测定空腹血糖（fasting blood glucose,FBG）、HbA1c、CysC及血脂水平。【结果】糖尿病（diabetic mellitus,DM）组FBG、HbA1c、CysC、血脂与对照组比较差异有统计学意义（P〈0.05）。糖尿病肾病早期组、中晚期组FBG（9.62±1.71）、（12.37±1.99）mmol/L]、HbA1c（8.37%±1.07%）、（12.37%±1.03%）]、CysC（1.78±0.51）、（6.29±0.52）mg/L]、血脂水平浓度升高,明显高于单纯糖尿病组（7.43±0.81）mmol/L、（6.24%±0.85%）、（1.03±0.62）mg/L,P〈0.05]。糖尿病肾病中晚期组FBG、HbA1c、CysC、血脂水平高于糖尿病肾病早期组（P〈0.05）。【结论】2型DN患者HbA1c、CysC、血脂水平均明显升高,其水平与患者微血管病变程度有关,提示HbA1c、CysC、血脂水平对DN早期诊断和疾病预防有积极意义。

Studies on glycosylated hemoglobin, cystatin C and serum lipid levels in diabetic nephropathy patients

【Objective】To study the changes and clinical significance of glycosylated hemoglobin,serum cystatin C and serum lipid levels in type 2 diabetic nephropathy（DN） patients.【Methods】According to the 24 hour urinary albumin excretion rate（UAER）,100 cases of type 2 diabetes mellitus（T2DM） were divided into three groups： simple diabetic mellitus group,early stage of diabetic nephropathy group and middle-late stage of diabetic nephropathy group.30 healthy volunteers were selected for control group.Fasting blood glucose（FBG）,glycosylated hemoglobin（HbA1c）,cystatin C,and serum lipid were measured【.Results】The differences of FBG,HbA1c,CysC and lipids were significantly different between the diabetic mellitus group and the control group（P 0.05）.In the early stage of diabetic nephropathy group and middle-late stage group,concentration of FBG（9.62±1.71）,（12.37±1.99）mmol/L],HbA1c （8.37%±1.07%）,（12.37%±1.03%）],CysC（1.78±0.51）、（6.29±0.52） mg/L],lipids were elevated and significantly higher than simple diabetic mellitus group（7.43±0.81） mmol/L,（6.24%±0.85%）、（1.03±0.62） mg/L,P 0.05].In the middle-late stage diabetic nephropathy group,FBG,HbA1c,CysC,Lipids were significantly higher than those in the early stage diabetic nephropathy group（P 0.05）【.Conclusion】HbA1c,CysC,Lipids were significantly increased,and their levels are correlated with the degrees of microvascular disease in type 2 DN,suggesting that the levels of HbA1c,CysC and lipids in DN are important in early diagnosis and prevention of the disease.