2型糖尿病下肢血管病变患者血浆同型半胱氨酸的改变及与Hs—CRP、血小板参数的关系

目的探讨2型糖尿病（T2DM）下肢血管病变患者血浆同型半胱氨酸（Hcy）的变化及与超敏C反应蛋白（Hs—CRP）、血小板参数的关系。方法98例T2DM患者，根据踝肱指数（ABI）分为T2DM伴下肢血管病变组（T2DMq-LLVD组）和r12DM不伴下肢血管病变组（T2DM组），同期选择健康体检48例作为正常对照（NC）组，用ELISA法检测各组空腹血浆Hcy浓度，分析了Hcy与Hs—CRP和血小板参数及其他指标的关系。结果T2DM组和T2DM＋LLVD组血浆Hcy水平明显高于NC组（17．3±4．1μmol／Lvs．13．7±2．6）μmol／Lvs．8．9±1．5μmol／L，P〈0．05）；T2DM＋LIⅣD组血浆Hcy水平明显高于T2DM组（17．3±4．1μmol／Lvs．13．7±2．6μmol／L，P〈0．05）。T2DM-I-LLVD组患者血浆Hcy水平与Hs—CRP、ABI、空腹血糖（FBG）、血小板平均体积（MPV）、血小板体积分布宽度（PDW）、HOMA一胰岛素抵抗指数（HOMA—IR）呈明显正相关（P〈0．05）。Hs—CRP、ABI和MPV是影响T2DM＋LLVD组患者血浆Hcy水平的独立相关因素。结论T2DM患者尤其是伴有下肢血管病变患者血浆Hcy水平明显增高，与血小板参数及炎症反应相关的动脉粥样硬化（AS）密切相关，可能与r12DM下肢血管病变的发生发展密切相关。

Study on relationship between plasma level of homocysteine with high - sensitivity C - reactive protein and platelet parameters in type 2 diabetes mellitas patients with vasculopathy in lower limbs.

Objective To observe the relationship between level of plasma homocysteine （Hey） with high sensivity C reactive protein （ Hs - CRP） and platelet parameters in type 2 diabetes mellitus （T2DM） patients with lower limb vasculopathy. Methods A total of 98 patients with newly diagnosed T2DM were divided into T2DM patients accompanied with lower limb vasculopathy group （51 cases in LLVD group） and T2DM patients without lower limb vasculopathy group （47 cases, T2DM group） according to ankle brachial index （ABI）, meanwhile 48 healthy persons for health examination were selected as control group （ NC group）. Fasting plasma level of Hcy was assayed by ELISA technique. The relationship between plasma level of Hcy with every index was also analyzed. Results The level of plasma Hcy was significantly higher in T2DM and T2DM ＋ LLVD groups than that in NC group （ P 〈 0.05 ）. Plasma level of Hcy was significantly higher in T2DM ＋ LLVD group than that in T2DM group （ P 〈 0.05 ）. Plasma level of Hcy in T2DM ＋ LLVD group was positively related to Hs - CRP, ankle brachial index （ABI） , fasting blood glucose （ FBG）, mean platelet volume （MPV） and platelet volume distribution width （ PDW）, insulin resistance index （ HOMA - IR） and fasting blood glucose （FBG） （ P 〈 0.05）. Multiple regression analysis showed that Hs -CRP, ABI and MPV were independent risk factors of plasma Hcy in patients with T2DM ＋ LLVD. Conclusion The plasma level of Hcy was significant higher in T2DM patients accompanied with lower limb vasculopathy. Plasma level of Hcy was closely correlated with atherosclerosis （AS） related inflammation reaction and platelet parameters, and they may play important role in the occurrence and development of lower limb vasculopathy in patients with T2DM.