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目的比较2型糖尿病(T2DM)肾病患者血清C-反应蛋白(CRP)水平变化并探讨其与代谢指标的关系。方法将148例T2DM患者设为糖尿病组(DM组),并根据24 h尿微量白蛋白分为三组:无肾病组55例(B组)、早期肾病组58例(C组)、临床肾病组35例(D组),30例健康体检者为对照组(A组)。测定血清CRP水平,同时检测血压、体质量指数(BM I)、空腹血糖(FPG)、血脂、尿酸(UA)、空腹胰岛素,计算胰岛素抵抗指数(HOMA-IR),观察各组间CRP变化并进行相关分析。结果①DM组与A组相比,收缩压(SBP)、FPG、HOMA-IR、甘油三酯(TG)、低密度脂蛋白-胆固醇(LDL-C)升高、UA升高(P<0.01或P<0.05),高密度脂蛋白-胆固醇(HDL-C)降低(P<0.05);D组与B组相比,SBP、UA升高(P<0.05),HDL-C降低(P<0.05);②B、C、D组CRP高于A组(P<0.01),C、D组CRP高于B组(P<0.01),D组CRP高于C组(P<0.05);③相关分析显示CRP与BM I、SBP、TG、LDL-C、HOMA-IR、UA存在显著正相关。结论 CRP与糖尿病肾病(DN)的发生相关,且随着DN进展而逐渐增高,可预测DN的进展;CRP水平升高与BM、ITG、LDL-C、UA、HOMA-IR等代谢指标密切相关,可作为T2DM患者心血管并发症的临床预测指标。
Objective To compare the changes of serum C-reactive protein (CRP) level in patients with type 2 diabetes mellitus (T2DM) with nephropathy and explore its relationship with metabolic parameters. Methods A total of 148 patients with T2DM were enrolled in this study. DM patients were divided into three groups according to their 24-hour urinary albumin: 55 cases without nephropathy (group B), 58 cases with early nephropathy (group C), clinical nephropathy 35 cases (group D) and 30 cases of healthy people as control group (group A). Serum CRP levels were measured at the same time, blood pressure, body mass index (BM I), fasting blood glucose (FPG), blood lipid, uric acid (UA), fasting insulin and HOMA-IR were calculated. Related analysis. Results ① The SBP, FPG, HOMA-IR, triglyceride (TG), LDL-C and UA in DM group were significantly higher than those in A group (P <0.01 or (P <0.05) and HDL-C (P <0.05). Compared with group B, SBP and UA in group D increased (P <0.05) and HDL-C decreased ); CRP in group B, C and D were higher than that in group A (P <0.01); CRP in group C and D were higher than that in group B (P <0.01); CRP in group D was higher than that in group C There was a significant positive correlation between CRP and BM I, SBP, TG, LDL-C, HOMA-IR and UA. Conclusions CRP is associated with the occurrence of diabetic nephropathy (DN) and gradually increases with the progress of DN, which can predict the progression of DN. CRP levels are closely related to the metabolic indexes such as BM, ITG, LDL-C, UA and HOMA-IR , Can be used as clinical predictors of cardiovascular complications in patients with T2DM.