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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(P<0.05);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(P<0.05);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。
Objective: To study the relationship between serum cystatin C and diabetic ventricular remodeling. Methods: Ninety diabetic patients diagnosed and treated in our hospital from October 2013 to October 2015 were enrolled in this study. Serum levels of cystatin C were detected in patients with diabetes mellitus. According to the median serum cystatin C level, Cystatin C level <1.65mg / L) and elevated group (Cystatin C level> 1.65mg / L). Left ventricular end diastolic diameter, left atrium diameter, left ventricular end-diastolic volume, interventricular septum thickness and left ventricular posterior wall thickness were measured by echocardiography, and left ventricular mass index was calculated. The two groups of these indicators were compared and analyzed the relationship between serum cystatin C and diabetic ventricular remodeling. Results Compared with the normal group, the levels of cystatin C, diastolic diameter, left atrial diameter, interventricular septum thickness, posterior wall thickness, left ventricular mass index and brain natriuretic peptide were significantly increased P <0.05). Correlation analysis showed that the level of serum cystatin C was positively correlated with left ventricular end diastolic diameter, left atrium diameter, interventricular septum thickness, left ventricular posterior wall thickness, left ventricular mass index and brain natriuretic peptide (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 brain natriuretic peptide were risk factors of elevated cystatin C levels. Conclusion: Serum levels of cystatin C are significantly correlated with cardiac function and ventricular remodeling in diabetic patients and may be used as a reference index to measure the degree of ventricular remodeling in diabetic patients.