目的 探讨2型糖尿病患者血浆糖化血红蛋白(HbA1C)、同型半胱氨酸(Hcy)、纤维蛋白原(Fib)水平与糖尿病微血管病变的关系.方法 选取我院收治的189例2型糖尿病患者作为研究对象,并选取同期门诊体检非糖尿病健康人60例作为对照组,测定空腹血糖、HbA1C、Hcy、Fib、尿微量白蛋白排泄率,并检查患者视网膜病变情况.结果 ①189例2型糖尿病患者中有视网膜病变者(DR)33例,无视网膜病变(NDR)者156例,DR组HbA1C值为(8.80±2.26)％,Hcy值为(25.38±7.78) μmol/L,Fib值为(4.62±1.09) g/L; NDR组HbA1C值为(6.83±1.03)％,Hcy值为(12.33±3.43) μmol/L,Fib值为(3.30±1.02) g/L,健康对照组HbA1C值为(5.05±0.57)％,Hcy值为(7.68±2.70) μmol/L,Fib值为(2.97±1.10) g/L,各组数据间差异具有统计学意义(P＜0.05).②189例2型糖尿病患者中有微量蛋白尿(UMA)的患者28例,无微量蛋白尿(NUMA)患者161例,UMA组HbA1C值为(8.91±2.18)％,Hcy值为(29.04±8.33) μmol/L,Fib值为(4.71±1.17)g/L;NUMA组HbA1C值为(6.75±1.07)％,Hcy值为(11.27±3.52)μmol/L,Fib值为(3.25±1.23) g/L；各组数据间差异具有统计学意义(P＜0.05).结论 2型糖尿病微血管并发症的发生与患者血浆糖化血红蛋白、同型半胱氨酸、纤维蛋白原水平有关,联合测定患者糖化血红蛋白、同型半胱氨酸、纤维蛋白原水平对糖尿病微血管病早期诊断有重要的临床意义.%Objective To explore the relationship between HbAlc, homocysteine, fibrinogen and microangiopathy in patients of type 2 diabetes. Methods One hundred and eighty-nine patients of type 2 diabetes were selected as research objects. Sixty healthy individuals were enrolled as the control group. The fasting blood glucose, plasma diabetes hemoglobin (HbA1C)2 homocysteine (Hcy), fibrinogen (Fib), urinary albumin excretion rate were tested, and the retinal lesions (DR) were examined. Results (1) Of the 189 patients, 33 patients were found with DR (the DR group), while 156 patients not (the NDR group). The levels of HbAlc, Hcy, Fib were (8.80±2.26)%, (25.38±7.78) μmol/L, (3.30±1.02) g/L in the DR group, (6.83±1.03)%, (12.33±3.43) μmol/L, (3.30±1.02) g/L in the NDR group, (5.05± 0.57)%, (7.68±2.70) umol/L, (4.71±1.17) g/L in the control group, respectively. Statistically significant difference was found in the levels between the three groups (P<0.05). (2) Of the 189 patients, 28 were found with microalbuminuria (the UMA group), while 161 not (the NUMA group). The levels of HbA,C, Hey, Fib were (8.91 ±2.18)%, (29.04± 8.33) μmol/L, (4.71±1.17) g/L in the UMA group, and (6.75±1.07)%, (11.27±3.52) μmol/L, (3.25±1.23) g/L in the NUMA group, showing statistically significant difference between the two groups (P<0.05). Conclusion The occurrence of microvascular complications in patients of type 2 diabetes is correlated with the levels of glycosylated hemoglobin, and plasma homocysteine and fibrinogen. Combined determination of their levels has great significance for the early diagnosis of diabetic microvascular disease.
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