目的 探讨糖尿病肾病患者B型钠尿肽(BNP)、同型半胱氨酸( HCY)和肌钙蛋白I(cTnI)的变化与其发生心血管疾病的关系.方法 将178例糖尿病肾病患者分为2组,即有心血管疾病组(CVD组)87例和没有心血管疾病组(NCVD组)91例,另取50例健康体检者为健康对照组,检测其血浆BNP,HCY和cTnI值并和其他生化指标:胱抑素C(CysC)、尿微量蛋白(M-TP)、肌酐(CREA)和尿素氮(BUN)等进行比较.结果 2组糖尿病肾病患者的肾功指标(CysC、M-TP、CREA和BUN)均较健康对照组高(P<0.01),且2组肾病患者之间BNP、HCY和cTnI差异有统计学意义(P<0.01),NCVD组的BNP和 HCY与肾功指标(CysC、M-TP、CREA和BUN)呈正相关(P<0.01),CVD组的BNP和cTnI显著升高与肾功指标(CysC、M-TP、CREA和BUN)无相关性;但应该注意的是,HCY与肾功能指标CysC、M-TP、CREA、BUN呈正相关(P<0.01).结论 BNP,HCY和cTnI可预测糖尿病肾病患者心血管疾病的发生,也可以作为反映其心血管功能的指标.%Objective To study the relationship between the changes of BNP, HCY and cTnI in patients with diabetic & ne phropathy and their cardiovascular diseases. Methods A total of 178 patients with diabetic and nephropathy were divided into two groups,namely,cardiovascular disease group (CVD group) 87 cases and non cardiovascular disease group (NCVD group) 91 pa tients. Meanwhile, 50 healthy subjects were selected as the normal reference group. The plasma BNP testing, HCY and cTnI values and other biochemical indicators (CysC,M TP,CREA and BUN,etc. ) from the reference group were used for comparison. Results Renal function (characterized as CysC, M TP, CREA and BUN) in patients with diabetic and nephropathy of the two groups were both higher than those of the normal reference group (as P＜0. 0l). The levels of BNP, HCY and cTnI between the two groups of kidney patients were also significantly different (as P＜ 0. 0l). In the NCVD group, BNP and HCY and renal function indicators (CysC, M TP, CREA and BUN) were positively correlated (as P＜0. 0l). However, in the CVD group, the increase of the BNP and cTnI had no correlation with the indicators of the renal function,i, e. CysC,M TP,CREA and BUN. It should be noted that HCY was positively correlated with the indicator of the renal function, i. e. CysC, M TP, CREA, BUN (P＜0. 0l). Conclusion The resuits of BNP, HCY and cTnI in patients with diabetic nephropathy can be used to predict their cardiovascular diseases as well as evaluate their cardiovascular function.
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