检验医学 ›› 2023, Vol. 38 ›› Issue (3): 282-286.DOI: 10.3969/j.issn.1673-8640.2023.03.015

• 论著 • 上一篇    下一篇

糖尿病心肌病患者HbA1c、NT-proBNP、Hcy、SOD和TC水平的变化及其临床意义

郑志友1, 李兴照2, 谢雅革3()   

  1. 1.合肥市第一人民医院滨湖医院,安徽 合肥 230041
    2.安徽医科大学第一附属医院,安徽 合肥 230061
    3.安徽中医药大学第一附属医院,安徽 合肥 230031
  • 收稿日期:2022-08-03 修回日期:2022-11-04 出版日期:2023-03-28 发布日期:2023-05-24
  • 通讯作者: 谢雅革
  • 作者简介:谢雅革,E-mail:978327452@qq.com
    郑志友,男,1985年生,学士,主管检验师,主要从事临床检验工作。

Changes and clinical significance of HbA1c,NT-proBNP,Hcy,SOD and TC levels in patients with diabetes cardiomyopathy

ZHENG Zhiyou1, LI Xingzhao2, XIE Yage3()   

  1. 1. Binhu Hospital,Hefei First People's Hospital,Hefei 230041,Anhui,China
    2. The First Affiliated Hospital of Anhui Medical University,Hefei 230061,Anhui,China
    3. The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,Anhui,China
  • Received:2022-08-03 Revised:2022-11-04 Online:2023-03-28 Published:2023-05-24
  • Contact: XIE Yage

摘要: 目的 探讨糖代谢指标[糖化血红蛋白(HbA1c)]、脂代谢指标[总胆固醇(TC)、三酰甘油(TG)]、氧化应激指标[同型半胱氨酸(Hcy)、β-羟丁酸(β-HB)、超氧化物歧化酶(SOD)]、炎症指标[C反应蛋白(CRP)]和心功能损伤指标[氨基末端B型钠尿肽原(NT-proBNP)]在糖尿病心肌病(DCM)中的临床应用价值。方法 选取2018年12月—2022年1月合肥市第一人民医院滨湖医院DCM患者60例(DCM组)、单纯糖尿病患者60例(对照组)。收集所有患者的一般资料,并检测HbA1c、NT-proBNP、Hcy、TC、TG、CRP、β-HB、SOD水平。采用Logistic回归分析评估发生DCM的危险因素。采用受试者工作特征(ROC)曲线评价各项指标单项检测和联合检测在鉴别诊断DCM中的效能。结果 DCM组HbA1c、NT-proBNP、Hcy、TC、TG、CRP和β-HB水平均显著高于对照组(P<0.05),SOD水平显著低于对照组(P<0.05)。Logistic回归分析结果显示,HbA1c、NT-proBNP、Hcy、SOD和TC均是糖尿病患者发生DCM的危险因素[比值比(OR)值分别为3.092、1.003、1.349、0.969、2.947,95%可信区间分别为1.187~8.051、1.000~1.006、1.088~1.673、0.943~0.995、1.159~7.494]。ROC曲线分析结果显示,HbA1c、NT-proBNP、Hcy、SOD、TC单项检测和5项指标联合检测鉴别诊断DCM的曲线下面积分别为0.615、0.613、0.650、0.608、0.603和0.683。结论 HbA1c、NT-proBNP、Hcy、SOD和TC在DCM的风险评估中有一定的价值。

关键词: 糖化血红蛋白, 氨基末端B型钠尿肽原, 同型半胱氨酸, 超氧化物歧化酶, 总胆固醇, 糖尿病心肌病

Abstract: Objective To investigate glucose metabolism [glycated hemoglobin A1c(HbA1c)],lipid metabolism [total cholesterol(TC) and triglyceride(TG)],oxidative stress [homocysteine(Hcy),beta-hydroxybutyric acid(beta-hydroxybutyrate,β-HB),superoxide dismutase(SOD)],inflammation [C-reactive protein(CRP)] and myocardial injury [amino-terminal B-type natriuretic peptide(NT-proBNP)] indicators in diabetes cardiomyopathy(DCM). Methods From December 2018 to January 2022,60 patients with DCM(DCM group) and 60 patients with simple diabetes(control group) from Binhu Hospital of Hefei First People's Hospital were enrolled,and the general data of all the patients were collected. HbA1c,NT-proBNP,Hcy,TC,TG,CRP,β-HB and SOD levels were determined. Logistic regression analysis was used to evaluate the risk factors of DCM. Receiver operating characteristic(ROC) curve was used to evaluate the value and predictive efficacy of various influencing factors in the auxiliary diagnosis of DCM. Results HbA1c,NT-proBNP,Hcy,TC,TG,CRP and β-HB levels were higher than those in control group(P<0.05). The level of SOD was lower than that in control group(P<0.05). Logistic regression analysis showed that HbA1c [odds ratio(OR)=3.092,95% confidence interval(CI)1.187-8.051],NT-proBNP(OR=1.003,95% CI 1.000-1.006),Hcy(OR=1.349,95% CI 1.088-1.673),SOD(OR=0.969,95% CI 0.943-0.995) and TC(OR=2.947,95% CI 1.159-7.494) were risk factors for DCM. The areas under curves of HbA1c,NT-proBNP,Hcy,SOD and TC single determinations and the combined determination were 0.615,0.613,0.650,0.608,0.603 and 0.683 in the differential diagnosis of DCM,respectively. Conclusions HbA1c,NT-proBNP,Hcy,SOD and TC are related to the occurrence of DCM.

Key words: Glycated hemoglobin A1c, Amino-terminal B-type natriuretic peptide, Homocysteine, Superoxide dismutase, Total cholesterol, Diabetes cardiomyopathy

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