本文選題：非對稱二甲基精氨酸 + 2型糖尿病�。� 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]探討2型糖尿病合并冠心病患者的血清非對稱二甲基精氨酸水平及其影響因素。[方法]隨機(jī)選取我院內(nèi)分泌科住院部2型糖尿病患者67例(其中單純糖尿病組39例,合并冠心病組28例),及在我院進(jìn)行體檢的無親緣關(guān)系的健康人33例,記錄研究對象的一般臨床資料、病史,檢驗(yàn)各血液生化指標(biāo),應(yīng)用酶聯(lián)免疫法吸附法檢測研究對象的血清ADMA濃度,比較分析各組間血清ADMA水平和相關(guān)臨床指標(biāo)。[結(jié)果]1.ADMA水平在2型糖尿病合并冠心病組單純2型糖尿病組健康對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),協(xié)方差分析校正TC、LDL、FPG等因素干擾后,ADMA水平在各組間差異仍有統(tǒng)計(jì)學(xué)意義(P0.05);2.TC、LDL、FPG、HBA1c、HOMA-IR在2型糖尿病合并冠心病組單純2型糖尿病組健康對照組,各組間差異均有統(tǒng)計(jì)學(xué)意義(P0.05);3.糖尿病病程在2型糖尿病合并冠心病組單純2型糖尿病組,差異有統(tǒng)計(jì)學(xué)意義(P0.05):4.HDL在2型糖尿病合并冠心病組單純2型糖尿病組健康對照組,各組間差異均有統(tǒng)計(jì)學(xué)意義(P0.5);5.TG、ALT、AST、2hPG在2型糖尿病合并冠心病組健康對照組,在單純2型糖尿病組健康對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),單純2型糖尿病組和2型糖尿病合并冠心病組間差異無統(tǒng)計(jì)學(xué)意義;6.年齡、性別構(gòu)成、SBP、DBP、BMI、WHR、BUN、Scr在三組人群之間差異無統(tǒng)計(jì)學(xué)意義(P0.05);7.Pearson 分析顯示血清 ADMA水平與病程、TC、TG、LDL、FPG、2hPG、HBA1c、HOMA-IR呈正相關(guān),與HDL呈負(fù)相關(guān),與年齡、SBP、DBP、BMI、WHR、ALT、AST、BUN、Scr無明顯相關(guān)性;8.多元回歸分析血清ADMA水平,HOMA-IR、HBA1c、LDL進(jìn)入方程,F=121.4,P0.01,回歸方程成立,標(biāo)準(zhǔn)化偏回歸系數(shù)分別為 0.326、0.319、0.230,HOMA-IR 對血清 ADMA 的影響比 HBA1c、LDL 更大;9.多元回歸分析2型糖尿病合并冠心病發(fā)生示:ADMA、LDL、HBA1c進(jìn)入方程,F=102.3,P0.01,回歸方程成立,標(biāo)準(zhǔn)化偏回歸系數(shù)分別為0.404、0.380、0.185,ADMA對2型糖尿病合并冠心病發(fā)生的影響比HBA1c、LDL更大。[結(jié)論]1.血清ADMA水平在2型糖尿病合并冠心病組單純2型糖尿病組健康對照組,差異有統(tǒng)計(jì)學(xué)意義,推測ADMA可能參與2型糖尿病合并冠心病的發(fā)生發(fā)展;2.影響血清ADMA水平的因素有HOMA-IR、LDL、HBA1c,影響2型糖尿病合并冠心病發(fā)生的因素有:HBA1c、LDL、ADMA,改善胰島素抵抗、降糖、降脂綜合治療可能有利于ADMA的減低,減緩2型糖尿病合并冠心病的發(fā)生發(fā)展進(jìn)程。
[Abstract]:Objective: to investigate the serum asymmetric dimethyl arginine level and its influencing factors in patients with type 2 diabetes mellitus complicated with coronary heart disease.[methods] Sixty-seven patients with type 2 diabetes mellitus in the Department of Endocrinology in our hospital were randomly selected, including 39 cases of simple diabetes mellitus group, 28 cases of coronary heart disease group, and 33 cases of unrelated healthy persons who were examined in our hospital.The general clinical data, medical history and blood biochemical indexes were recorded. The serum ADMA concentration was detected by enzyme linked immunosorbent assay (Elisa), and the serum ADMA levels and related clinical indexes were compared and analyzed among each group.[results] the level of 1.ADMA in type 2 diabetes with coronary heart disease group was normal control group.There was significant difference in ADMA level between the two groups after adjusted by covariance analysis of TCU LDLN FPG and other factors. 2. The level of ADMA in type 2 diabetes complicated with coronary heart disease group was significantly higher than that in the control group with type 2 diabetes mellitus (type 2 diabetes mellitus and coronary heart disease alone), and there was no significant difference in the level of ADMA between the two groups (P < 0. 05 or P 0. 05). 2. The level of ADMA in patients with type 2 diabetes mellitus complicated with coronary heart disease was significantly different.The differences among the groups were statistically significant (P 0.05).The course of diabetes in type 2 diabetes complicated with coronary heart disease group, the difference was statistically significant in type 2 diabetes mellitus with coronary heart disease group, the difference was statistically significant in type 2 diabetes mellitus with coronary heart disease group, the difference was significant in type 2 diabetes mellitus with coronary heart disease group, type 2 diabetes mellitus group was healthy control group.There were significant differences among the three groups (P0. 5). 5. The level of alt AST2hPG in patients with type 2 diabetes complicated with coronary heart disease was significantly higher than that in patients with type 2 diabetes mellitus and only type 2 diabetes, and there was no significant difference between the two groups.The difference was statistically significant (P 0.05). There was no significant difference between type 2 diabetes mellitus and type 2 diabetes mellitus with coronary heart disease.There was no significant difference in serum ADMA level between the three groups. Pearson analysis showed that the level of serum ADMA was positively correlated with the course of disease, and negatively correlated with HDL. There was no significant correlation between serum ADMA level and HDL.Multivariate regression analysis showed that the serum ADMA level of HOMA-IRN HBA1cP0. 01, the regression equation was established, the normalized partial regression coefficient was 0. 326 ~ 0. 319 ~ 0. 230 Homa-IR had a greater effect on serum ADMA than HBA1 / cLDL.Multivariate regression analysis showed that the incidence of type 2 diabetes mellitus complicated with coronary heart disease (CHD) was higher than that of HBA1c in type 2 diabetes mellitus complicated with coronary heart disease. The regression equation was established and the standardized partial regression coefficient was 0.404 ~ 0.380 ~ 0.185% ADMA was more effective than HBA1cLDL in the occurrence of type 2 diabetes mellitus with coronary heart disease.[conclusion] 1.The level of serum ADMA in type 2 diabetic patients with coronary heart disease was significantly higher than that in healthy controls. It was speculated that ADMA might be involved in the occurrence and development of type 2 diabetes mellitus with coronary heart disease (CHD).The factors influencing the serum ADMA level were HOMA-IRN LDLL + HBA1c, and the factors affecting the occurrence of type 2 diabetes mellitus complicated with coronary heart disease were: 1 / HBA1 / LDL-ADMA. improving insulin resistance, lowering blood glucose and lowering lipid may be beneficial to the decrease of ADMA.To slow down the development of type 2 diabetes with coronary heart disease.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R587.2;R541.4

【參考文獻(xiàn)】

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1 Hiroyuki Konya;Masayuki Miuchi;Kahori Satani;Satoshi Matsutani;Yuzo Yano;Taku Tsunoda;Takashi Ikawa;Toshihiro Matsuo;Fumihiro Ochi;Yoshiki Kusunoki;Masaru Tokuda;Tomoyuki Katsuno;Tomoya Hamaguchi;Jun-ichiro Miyagawa;Mitsuyoshi Namba;;Asymmetric dimethylarginine, a biomarker of cardiovascular complications in diabetes mellitus[J];World Journal of Experimental Medicine;2015年02期

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