【摘要】  目的  探讨血浆心钠素（ANP）、脑利钠肽（BNP）、C型利钠肽（CNP）水平在老年T2DM合并血管病变患者中的变化及意义。  方法  选取老年T2DM患者120例，根据是否合并血管病变分为合并血管病变组44例和单纯T2DM组76例，另选取同期健康体检者60名作为对照（NC）组，检测3组血糖、血脂、ANP、BNP、CNP及血小板内皮细胞黏附因子-1（PECAM-1）等指标，并进行分析。  结果  血管病变组ANP[（3.59±1.72） vs （2.39±1.04） vs （2.70±1.58） nmol/L]、BNP[（0.39±0.10） vs （0.26±0.08） vs （0.23±0.09） nmol/L]、PECAM-1[（6.98±1.30） vs （3.29±1.04） vs （4.61±1.17） μg/L]高于NC组和单纯T2DM组（P＜0.05）；CNP[（2.20±1.18） vs （3.37±1.27） vs （4.29±1.09） nmol/L]低于NC组和单纯T2DM组（P＜0.05）。多元线性回归显示，ANP、BNP与PECAM-1呈正相关，CNP与PECAM-1呈负相关（P＜0.05）。  结论  ANP、BNP、CNP在老年T2DM血管病变患者水平发生变化，其可作为诊断T2DM患者血管病变的指标。

【关键词】  血浆心钠素；脑利钠肽；C型利钠肽；糖尿病，2型；血管病变

The changes and clinical significance of ANP, BNP and CNP in type 2 diabetes with angiopathy  LIU Mei. Department of Emergency, The First Teaching Hospital of Tianjin University of TCM, Tianjin 300193, China

【Abstract】  Objective  To explore the changes and clinical significance of plasma atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP) levels in type 2 diabetes mellitus (T2DM) with vascular lesions.  Methods  120 cases of T2DM elders were divided into group with vascular disease(n=44) and  group without vascular disease (n=76). 60 cases of healthy subjects were set as control group. The levels of glucose, lipid, ANP, BNP，CNP and platelet endothelial cell adhesion molecule-1 (PECAM-1) were measured and analyzed.  Results  The levels of ANP[（3.59±1.72） vs （2.39±1.04） vs （2.70±1.58） nmol/L], BNP[（0.39±0.10） vs （0.26±0.08） vs （0.23±0.09） nmol/L] and PECAM-1[（6.98±1.30） vs （3.29±1.04） vs （4.61±1.17） μg/L] in vascular group were higher than that in control group and simple T2DM group（P＜0.05）；the levels of CNP[（2.20±1.18） vs （3.37±1.27） vs （4.29±1.09） nmol/L] in vascular group were lower（P＜0.05）. Multiple linear regression analysis showed that ANP and BNP were positively correlated with PECAM-1, and CNP was negatively correlated with PECAM-1 (P＜0.05).  Conclusion  The changes of ANP, BNP and CNP  indicated that these indicators can be used as biomarkers of T2DM patients with vascular disease.

【Key  words】  Atrial natriuretic peptide(ANP); Brain natriuretic peptide(BNP); C-type natriuretic peptide(CNP); Diabetes mellitus, type 2; Vasculopathy