中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
30期
1-4
,共4页
王曼曼%舒冏%陈宣蓉%穆攀伟%陈燕铭%曾龙驿
王曼曼%舒冏%陳宣蓉%穆攀偉%陳燕銘%曾龍驛
왕만만%서경%진선용%목반위%진연명%증룡역
糖尿病,2型%冠状动脉疾病%胱抑素C%320排动态容积CT
糖尿病,2型%冠狀動脈疾病%胱抑素C%320排動態容積CT
당뇨병,2형%관상동맥질병%광억소C%320배동태용적CT
Diabetes mellitus,type 2%Coronary disease%Cystatin C%320-dynamic volume computed tomography
目的 探讨尿蛋白正常的2型糖尿病患者血清胱抑素C与冠状动脉病变的关系.方法 将126例尿蛋白正常的2型糖尿病患者根据320排动态容积CT示冠状动脉狭窄情况分为冠状动脉正常组(A组,32例)、冠状动脉粥样硬化组(B组,38例)、冠心病组(C组,56例),对比三组间血清胱抑素C等.结果 A、B、C组血清胱抑素C水平分别为(0.89±0.27)、(1.31±0.53)、(1.54±0.62) mg/L,随着冠状动脉病变的加重逐渐升高,差异有统计学意义(P＜0.05).将患者按血清胱抑素C水平四分位法分成三组,随着血清胱抑素C水平的逐级升高,冠状动脉病变的发生率也呈升高趋势,当血清胱抑素C水平由第75％分位数升至第100％分位数,冠状动脉病变的发生率显著升高(OR=8.32,P＜ 0.05).多元Logistic回归分析结果显示,影响2型糖尿病患者冠心病发生的独立危险因素有高血压病史(回归系数4.135,P=0.000)、糖化血红蛋白(回归系数1.257,P=0.002)、低密度脂蛋白胆固醇(回归系数3.381,P=0.015)、胱抑素C(回归系数2.046,P=0.030).结论 血清胱抑素C水平可能可以预测尿蛋白正常的2型糖尿病患者罹患冠心病的风险.
目的 探討尿蛋白正常的2型糖尿病患者血清胱抑素C與冠狀動脈病變的關繫.方法 將126例尿蛋白正常的2型糖尿病患者根據320排動態容積CT示冠狀動脈狹窄情況分為冠狀動脈正常組(A組,32例)、冠狀動脈粥樣硬化組(B組,38例)、冠心病組(C組,56例),對比三組間血清胱抑素C等.結果 A、B、C組血清胱抑素C水平分彆為(0.89±0.27)、(1.31±0.53)、(1.54±0.62) mg/L,隨著冠狀動脈病變的加重逐漸升高,差異有統計學意義(P＜0.05).將患者按血清胱抑素C水平四分位法分成三組,隨著血清胱抑素C水平的逐級升高,冠狀動脈病變的髮生率也呈升高趨勢,噹血清胱抑素C水平由第75％分位數升至第100％分位數,冠狀動脈病變的髮生率顯著升高(OR=8.32,P＜ 0.05).多元Logistic迴歸分析結果顯示,影響2型糖尿病患者冠心病髮生的獨立危險因素有高血壓病史(迴歸繫數4.135,P=0.000)、糖化血紅蛋白(迴歸繫數1.257,P=0.002)、低密度脂蛋白膽固醇(迴歸繫數3.381,P=0.015)、胱抑素C(迴歸繫數2.046,P=0.030).結論 血清胱抑素C水平可能可以預測尿蛋白正常的2型糖尿病患者罹患冠心病的風險.
목적 탐토뇨단백정상적2형당뇨병환자혈청광억소C여관상동맥병변적관계.방법 장126례뇨단백정상적2형당뇨병환자근거320배동태용적CT시관상동맥협착정황분위관상동맥정상조(A조,32례)、관상동맥죽양경화조(B조,38례)、관심병조(C조,56례),대비삼조간혈청광억소C등.결과 A、B、C조혈청광억소C수평분별위(0.89±0.27)、(1.31±0.53)、(1.54±0.62) mg/L,수착관상동맥병변적가중축점승고,차이유통계학의의(P＜0.05).장환자안혈청광억소C수평사분위법분성삼조,수착혈청광억소C수평적축급승고,관상동맥병변적발생솔야정승고추세,당혈청광억소C수평유제75％분위수승지제100％분위수,관상동맥병변적발생솔현저승고(OR=8.32,P＜ 0.05).다원Logistic회귀분석결과현시,영향2형당뇨병환자관심병발생적독립위험인소유고혈압병사(회귀계수4.135,P=0.000)、당화혈홍단백(회귀계수1.257,P=0.002)、저밀도지단백담고순(회귀계수3.381,P=0.015)、광억소C(회귀계수2.046,P=0.030).결론 혈청광억소C수평가능가이예측뇨단백정상적2형당뇨병환자리환관심병적풍험.
Objective To investigate the relationship between serum cystatin C and coronary artery disease in type 2 diabetes mellitus (T2DM) patients with normal uric protein.Methods According to the coronary artery lesion diagnosed by 320-dynamic volume CT,the 126 T2DM patients with normal uric protein were divided into three groups:no coronary stenosis group (group A,32 cases),coronary atherosclerosis group(group B,38 cases),coronary heart disease group (group C,56 cases).Then the serum cystatin C etc were compared among the three groups.Results The levels of serum cystatin C in group A,B,C were (0.89 ± 0.27),(1.31 ± 0.53),(1.54 ± 0.62) mg/L.With the increase of coronary artery lesions,it gradually increased,there was significant difference among the three groups (P ＜ 0.05).The patients were divided into three groups according to the level of serum cystatin C quartile.The incidence of coronary artery lesion in creased with the increased levels of serum cystatin C.The level of serum cystatin C increased from 75th percentile to 100th percentile,the incidence of coronary heart disease increased significantly (OR =8.32,P ＜0.05).The result of multiple Logistic regression analysis showed that history of hypertension (regression coefficient 4.135,P =0.000),glycosylated hemoglobin (regression coefficient 1.257,P =0.002),low density lipoprotein-cholesterol (regression coefficient 3.381,P =0.015),cystatin C (regression coefficient 2.046,P =0.030) were the independent risks of coronary heart disease in patients with T2DM.Conclusion The level of serum cystatin C may be a predictor for coronary heart disease in T2DM patients with normal uric protein.
