糖尿病肾病肾功能不全患者血清单核细胞趋化蛋白-1水平变化  

Changes of Serum Monocyte Chemoattractant Protein-1 Level in Patients with Diabetic Nephropathy and Renal Insufficiency

作　　者：刘宁[1] 翟艳苓[2] 

机构地区：[1]首都医科大学附属北京同仁医院肾内科,北京市100730 [2]首都医科大学附属北京同仁医院血液内科,北京市100730

出　　处：《中国全科医学》2009年第14期1262-1264,共3页Chinese General Practice

摘　　要：目的探讨不同程度的糖尿病肾病(DN)患者血清单核细胞趋化蛋白-1(MCP-1)的水平及其意义。方法76例2型糖尿病患者分别按尿蛋白定量(UMA)及血清肌酐(Cr)水平分为3组:正常蛋白尿正常肾功能组(A组)UMA≤30mg/24h,Cr≤97μmol/L(女),106μmol/L(男)、显性蛋白尿正常肾功能组(B组)UMA≥300mg/24h,Cr≤97μmol/L(女),106μmol/L(男)和显性蛋白尿合并肾功能不全组(C组)UMA≥300mg/24h,Cr>97μmol/L(女),106μmol/L(男)。选择同期在我院门诊行健康体检的26名健康人作为正常对照组。用酶联免疫吸附法(ELISA法)检测血清MCP-1,并检测糖化血红蛋白(GHbA1c)、血清尿素氮(BUN)、Cr以及尿UMA水平。结果A组患者血清MCP-1水平为(131.1±48.2)ng/L,B组为(265.3±115.4)ng/L,C组为(467.2±101.2)ng/L,正常对照组为(59.3±24.3)ng/L,4组患者血清MCP-1水平比较差异有统计学意义(F=114.01,P<0.05)。多元逐步回归分析显示,对糖尿病显性蛋白尿合并肾功能不全患者影响作用由大到小依次为:尿UMA、GHbA1c和Cr,回归方程复相关系数r=0.517。结论2型糖尿病患者血清MCP-1水平较正常人高,且随着蛋白尿增加和肾功能不全,这种变化更加明显,这种变化可能是高血糖、内皮细胞损伤和毒素刺激共同作用的结果。Objective To investigate the serum levels of monocyte chemoattractant protein-1(MCP-1) in type 2-diabetes mellitus(T2DM) patients with different levels of albuminuria and renal function.Methods Seventy-six T2DM patients were divided into group A with normal albuminuria and renal function (UMA≤30mg/24h,Cr≤97μmol/L in females,106μmol/L in males),group B with macroalbuminuria and normal renal function (UMA≥300 mg/24 h,Cr≤97μmol/L in females,106μmol/L in males),and group C with macroalbuminuria complicated by renal insufficiency(RI) (UMA≥300 mg/24h,Cr>97μmol/L in females,106μmol/L in males).And 26 healthy subjects were enrolled as controls.Serum MCP-1,glycosylated hemoglobin(GHbA1c),blood urea nitrogen(BUN),Cr and UMA were determined by enzyme linked immunoabsorbent assay(ELISA).Results The serum MCP-1 level was 131.1±48.2 pg/ml in group A,significantly higher than in controls (59.3±24.3pg/ml,P<0.01),265.3±115.4 pg/ml in group B,higher than in group A (P<0.01),467.2±101.2 pg/ml in group C,higher than in groups B (P<0.05),A (P<0.01).Multiple regression analysis disclosed that the primary factors influencing MCP-1 were UMA(Beta=0.637,P<0.05),GHbA1c(Beta=0.597,P<0.01),Cr(Beta=0.485,P<0.01).Conclusion MCP-1 is higher in T2DM patients than in normal subjects,changing more obviously with albuminuria increase and RI development,which may be the results of joint effects of high blood sugar,endotheliocyte injury and toxin stimulation.

关 键 词：单核细胞趋化蛋白-1 糖尿病肾病 慢性肾功能不全 尿微量白蛋白 

分 类 号：R587.1[医药卫生—内分泌]