2型糖尿病患者肾微循环功能障碍、超敏C反应蛋白与心血管重构的关系

摘要

目的：探讨2型糖尿病患者肾微循环功能障碍、超敏C反应蛋白与心血管重构的关系。方法选取2型糖尿病患者73例，按是否合并肾脏微循环功能障碍分为肾脏微循环功能障碍组（40例）和无肾脏微循环功能障碍组（33例），另选取同期体检正常的健康者50例作为对照组。分别检测空腹血糖、餐后2 h 血糖、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、尿素氮、肌酐、超敏C 反应蛋白（hs-CRP）；超声检测颈动脉内膜中层厚度（IMT）及斑块，心脏彩色多普勒测量左室舒张末内径、室间隔厚度、左室后壁厚度，计算左室重量指数（LVMI）。结果肾脏微循环功能障碍组LVMI、IMT、斑块积分、hs-CRP 水平显著高于无肾脏微循环功能障碍组，无肾脏微循环功能障碍组上述指标水平显著高于对照组（P ＜0．05）。结论 2型糖尿病患者心血管重构可能与肾微循环功能障碍、hs-CRP 升高有关。%Objective To explore the relationship of renal microcirculation function disorder and high -sensitivity C-reactive protein(hs-CRP) with cardiovascular remodeling in patients with type 2 diabetes mellitus.Methods Seventy-three cases of type 2 diabetes mellitus were divided into renal microcirculation function disorder group (40 cases) and non-renal microcirculation function disorder group (33 cases) based on whether complicated with renal microcirculation function disorder,and 50 healthy cases were enrolled in the control group .Fasting blood glucose,2-hour postprandial blood glucose, total cholesterol(TC),triglycerides,high density lipoprotein(HDL),low density lipoprotein(LDL),urea nitrogen,creatinine and hs-CRP were tested .The carotid intima-media thickness ( IMT ) and plaque were measured with ultrasound , left ventricular end diastolic diameter , interventricular septal thickness , left ventricular posterior wall were determined by Color Doppler echocardiography ,and left ventricular mass index (LVMI) was calculated.Results LVMI,IMT,plaque score and hs-CRP level in the renal microcirculation function disorder group were significantly higher than those in the non-renal microcirculation function disorder group , and the indexes above in the non-renal microcirculation function disorder group were significantly higher than the controls (P<0.05).Conclusion Cardiovascular remodeling might correlate with renal microcirculation function disorder and increased hs -CRP in patients with type 2 diabetes mellitus .