血清胱抑素C 水平与糖尿病心室重构关系的临床研究

目的:研究血清胱抑素C水平与糖尿病心室重构的关系。方法:选择2013年10月~2015年10月在我院进行诊治的糖尿病患者90例,检测血清胱抑素C水平,按照糖尿病患者血清胱抑素C水平的中位数,分为正常组(胱抑素C水平1.65mg/L)和升高组(胱抑素C水平1.65mg/L)。行超声心动图检测左室舒张末内径、左房内径、左室舒张末容积、室间隔厚度和左室后壁厚度,并计算出左室质量指数。对两组的这些指标进行比较,并分析血清胱抑素C与糖尿病心室重构的相关性。结果:与正常组相比,升高组的胱抑素C、左室舒张末内径、左房内径、室间隔厚度、左室后壁厚度、左室质量指数和脑钠肽水平均明显增高(P0.05);经过相关性分析,血清胱抑素C水平与左室舒张末内径、左房内径、室间隔厚度、左室后壁厚度、左室质量指数和脑钠肽均呈正相关(P0.05);Logistic回归分析显示左室舒张末内径、左房内径、室间隔厚度、左室后壁厚度、左室质量指数和脑钠肽等是胱抑素C水平升高的危险因素。结论:血清胱抑素C水平与糖尿病患者的心功能和心室重构具有明显相关性,可作为衡量糖尿病患者心室重构程度的一项参考指标。

Correlation of the SerumCystatin C Level with the Ventricular Remodelingin Diabetes

Objective:To study the serumcystatinC levels and its relevance to diabetes ventricular remodeling.Methods:Selected80 cases of patients with diabetes who were treated in our hospital from December 2013 to December 2015. The serum cystatin C levelswere detected, according to the average levels of cystatin C, the patients were divided into normal group (cystatin C<1.65 mg/L) and elevatedgroup (cystatin C>1.65 mg/L). Using echocardiography to detect the left ventricular end-diastolic diameter, left atrial diameter, interventricularseptum thickness, left ventricular end-diastolic volume and left ventricular posterior wall thickness, and left ventricularmass index was calculated. Compare these indicators of the two groups and analyze the relationship of serum cystatin C levels with diabetesventricular remodeling.Results:Compared with normal group, the serumcystatin C, left ventricular end-diastolic diameter, left atrialdiameter, interventricular septum thickness, left ventricular posterior wall thickness, left ventricular mass index and brain natriureticpeptide levels of elevated group were significantly increased(P<0.05); through correlation analysis, there was a positive correlation of theserum cystatin C level and left ventricular end-diastolic diameter, left atrial diameter, interventricular septum thickness, left ventricularposterior wall thickness, left ventricular mass index (P<0.05); Logistic regression analysis showed that left ventricular end-diastolic diameter,left atrial diameter, interventricular septum thickness, left ventricular posterior wall thickness, left ventricular mass index and brainnatriuretic peptide were risk factors for cystatin C.Conclusion:The serum cystatin C in patients with diabetes mellitus has obvious correlationwith cardiac function and ventricular remodeling, can be used as an indicator to measure the degree of ventricular remodeling inpatients with diabetes.