2型糖尿病患者血清细胞外基质水平与糖尿病肾病的关系研究  

Relationship between Serum Extracellular Matrix Levels and Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus

作　　者：李晨钟[1] 薛耀明[1] 沈洁[1] 

机构地区：[1]第一军医大学南方医院内分泌科,广东省广州市510515

出　　处：《中国全科医学》2004年第21期1558-1560,共3页Chinese General Practice

基　　金：广东省卫生厅基金项目 (A2 0 0 0 378)

摘　　要：目的　探讨 2型糖尿病患者血清细胞外基质 (ECM)水平与糖尿病肾病 (DN)之间的关系。方法　运用放射免疫法检测 78例 2型糖尿病患者和 2 5名健康者的血清Ⅳ型胶原 (CⅣ )、层粘蛋白 (LAN)、前胶原 3(PⅢ )和透明质酸 (HA) 4种ECM水平。糖尿病患者按尿白蛋白排泌率 (UAER)分为糖尿病肾病组 (DN)和非糖尿病肾病组(NDN) ,DN组进一步根据UAER值分为微量白蛋白尿组 (MA ,UAER 30～ 30 0mg 2 4h)和临床肾病组 (CDN ,UAER≥30 0mg 2 4h)。结果　DN组和NDN组的血清CⅣ、LAN水平与对照组间差异有显著性意义 ,DN组的血清CⅣ、LAN水平与NDN组间差异有显著性意义 (P <0 0 1)。DN患者进一步分组后 ,CDN组的血清CⅣ、LAN水平与MA组间差异有显著性意义 (P <0 0 5 )。糖尿病患者血清CⅣ、LAN水平均分别与空腹血糖 (FPG)、舒张压和病程呈正相关。结论　 2型糖尿病患者血清CⅣ、LAN水平高于正常人 ,而且与DN的发生。Objective To investigate the relationship between serum extracellular matrix (ECM) levels and diabetic nephropathy (DN) in type 2 diabetic patients.Methods Serum extracellular matrix levels including collagen Ⅳ(CⅣ), laminin (LAN), procollagen Ⅲ ( PⅢ) and hyaluronic acid (HA) were determined with radioimmunoassay method in 78 patients with type 2 diabetes mellitus and 25 normal controls. Diabetic patients were divided into patients with diabetic nephropathy (DN) and patients without DN (NDN) according to their urine albumin elution rate (UAER).Moreover, patients with DN were divided into patients with microalbuminuria (MA,UAER 30～300 mg/24 h) and patients with clinical DN (CDN, UAER≥300 mg/24 h).Results In both patients with DN and patients without DN, serum CⅣ and LAN were higher than those in normal subject (P<0.01). Serum CⅣ and LAN of patients with DN were increased as compared with patients without DN (P<0.05). Moreover, serum CⅣ and LAN in patients with microalbuminuria were lower than those in patients with clinical DN. Liner regression analysis in diabetic patients showed that both of serum CⅣ and LAN were positively correlated with fasting plasma glucose (FPG), diastolic blood pressure and duration of diabetes, respectively.Conclusion Serum CⅣ and LAN were increased in patients with type 2 diabetes as compared with normal subjects, and had the close relationship with the happenness and development of diabetic nephropathy (DN).

关 键 词：DN 血清 患者 2型糖尿病 UAER 糖尿病肾病 细胞外基质 水平 平均分 显著性 

分 类 号：R587[医药卫生—内分泌] R692[医药卫生—内科学]