炎症在2型糖尿病患者肾功能损害中的作用  

The significance of inflammation on renal damage in patients with type2 diabetes mellitus

作　　者：刘东[1] 伦立德[1] 郑晓勇[1] 

机构地区：[1]北京空军总医院肾病科,100036

出　　处：《临床内科杂志》2005年第2期98-100,共3页Journal of Clinical Internal Medicine

摘　　要：目的　探讨炎症在2型糖尿病(DM)肾功能损害中的作用。方法　60例2型糖尿病 患者[依据尿白蛋白排泄率(UAER)和内生肌酐清除率(Ccr)分为单纯DM组20例,糖尿病肾病 (DN)肾功能正常组20例,DN肾功能不全组20例]和20例健康人,分别用免疫比浊法测定血浆C 反应蛋白(CRP),放免法测定血浆肿瘤坏死因子α(TNFα),白介素1β(IL1β),白介素6(IL6)。结 果　2型糖尿病患者血浆CRP,TNFα,IL1β,IL6水平升高,且随肾脏损害的加重而进一步增高,多 元线性回归分析表明Ccr与病程、IL1β、收缩压(SBP)呈直线相关,24小时尿蛋白排泄量(UPER)与 血浆IL6、SBP、TNFα水平呈直线相关。结论　2型糖尿病患者存在炎症反应,炎症在糖尿病肾功能 损害中起重要作用。Object To study the influence of inflammatory mediators on renal damage in patients with type2 diabetes mellitus.Methods The study included 20 healthy subjects and 60 patients with type2 diabetic mellitus.Diabetic patients were further divided into three subjects according to their urinary albumin excretion rate(UAER),urinary protein excretion rate(UPER) and endogenous creatinine clearance rate(Ccr). Plasma C-reactive protein(CRP) was measured with immunonephelometry methods;tumor necrosis factor-alpha(TNF-α),interleukin-1beta (IL1β),interleukin-6 (IL6) were measured with radioimmunoassay methods.Results Plasma CRP,TNFα,IL1β,IL6 levels were higher in diabetic patients with or without renal damage compared to healthy men.Increase in inflammatory mediators was correlated with the severity of renal damage.In multiple linear regression models,course,plasma IL1β and SBP were associated with Ccr;plasma IL6,SBP and TNFα were associated with UPER.Conclusions There is inflammatory reaction in type2 diabetes mellitus.Inflammation plays a pivotal role in the pathogenesis of renal damage in type2 diabetes mellitus.

关 键 词：糖尿病 非胰岛素依赖型 糖尿病肾病 炎症介质 肾功能损害 

分 类 号：R587.1[医药卫生—内分泌]