同型半胱氨酸与糖尿病肾病的关系及叶酸、甲钴胺的治疗效果

目的 研究同型半胱氨酸与糖尿病肾病的发病关系及叶酸、甲钴胺降低血浆Hcy水平的效果.方法 (1)血浆Hcy与糖尿病肾病关系研究:选取健康者30例为对照组,2型糖尿病患者50例,其中糖尿病肾病患者25例,测定3组受检者SBP、DBP及血浆Hcy、FBG、TG、HDL、LDL并分析其余糖尿病肾病的相关性.(2)糖尿病肾病患者Hcy水平干预研究:将60例2型糖尿病患者随机分为A、B两组各30例,A组患者未予干预.B组患者给予口服叶酸及甲钴胺干预治疗8周,比较干预前后血浆Hcy水平的变化.结果 非DN组和DN组患者Hcy水平均显著高于对照组(P＜0.05)且DN组显著高于非DN组(P＜0.01),多因素分析得Hcy是糖尿病肾病的独立危险因素.干预后患者血浆Hcy水平显著下降且显著低于对照组(P＜ 0.01).结论 Hcy是糖尿病肾病的独立危险因素,且叶酸联合甲钴胺治疗可显著降低2型糖尿病患者血浆Hcy水平.

Relationship between Hcy and DN and the effect of folic acid combined with methylcobalamin in the level of homocysteine

Objective To research the relationship between Hcy and DN and observe the effect of folic acid and methylcobalamin in the level of Hcy. Methods The blood samples of normal people, DM patients and DN patients were measured to compare the levels of Hcy, FBG, TG, HDL, LDL. 60 T2DM patients were divided into group A and group B, 30 patients in group B were treated with folic acid and methylcobalamin for 8 weeks. Results The level of Hcy of DM group and DN group were all significantly higher than that of control group, and the level of Hcy of DN group was higher than that of DM group（P〈 0.05）. Multivariate analysis showed Hcy level was the independent risk factor of DN. The Hcy level of group B was significantly higher than that of group A after treatment（P 〈 0.01）. Conclusion Hcy is the independent risk factors of DN; folic acid and methylcobalamin are remarkable effective in reducing Hcy level.