糖尿病肾病患者尿液糜蛋白酶检测及其病理意义分析  

A study of urinary chymase expression in patients with diabetic nephropathy

作　　者：郑敬民[1] 尹广[1] 恽时锋[1] 刘志红[1] 

机构地区：[1]南京军区南京总医院国家肾脏疾病临床医学研究中心,全军肾脏病研究所,江苏南京210002

出　　处：《东南国防医药》2014年第3期233-236,共4页Military Medical Journal of Southeast China

基　　金：江苏省自然科学基金资助项目(BK2012779)

摘　　要：目的了解肥大细胞糜蛋白酶在糖尿病肾病患者尿液中的表达及其与糖尿病肾病临床指标的相关性,探讨糜蛋白酶和肥大细胞在糖尿病肾病肾组织损伤中的作用。方法收集糖尿病肾病103例(包括糖尿病肾病早期10例、中期31例和晚期62例)和20例正常对照者的尿液;利用ELISA法检测尿中糜蛋白酶水平;比较分析尿液糜蛋白酶在正常对照组、糖尿病肾病早期组、中期组和晚期组中的变化情况及其与患者各临床指标的相关性。结果与正常对照组相比,糖尿病肾病患者尿液中糜蛋白酶的水平显著升高,表现为随糖尿病肾病的发展而逐渐增加的趋势。糖尿病肾病患者尿液糜蛋白酶水平与血肌酐[相关系数(r)=0.446,P<0.01]、血胱蛋白酶抑制剂C(r=0.398,P<0.01)、血尿素氮(r=0.365,P<0.01)、24 h尿蛋白(r=0.512,P<0.01)、尿C3(r=0.321,P<0.01)、尿视黄醇结合蛋白(r=0.432,P<0.01)、尿溶菌酶(r=0.482,P<0.01)、尿N-乙酰-β-葡萄糖苷酶(r=0.582,P<0.01)水平具有显著相关性。结论上述结果支持关于肥大细胞参与糖尿病肾病肾组织损伤的观点,提示肾组织肥大细胞及其分泌的糜蛋白酶很可能在糖尿病肾病肾组织损伤中具有重要作用并可能是糖尿病肾病防治的新靶标。Objective To observe the expression of chymase in the urine of patients with diabetic nephropathy and its correla -tion with clinical indices .Methods Urine samples from 20 normal controls and 103 patients with diabetic nephropathy were collected . Among these patients ,10 were identified to be at the early stage （ microalbuminuria stage ） ,31 were identified to be at the middle stage （ proteinuria stage ） and 62 were identified to be at the late stage （ renal insufficiency stage ） .The level of chymase in each urine sample was measured by an ELISA kit .Its correlation with clinical indices was carried out .Results The urinary chymase level was found in-creased with the development of diabetic nephropathy .The urinary chymase level was found correlated significantly with serum creati-nine,serum cystatin C,serum urea nitrogen,24 hour urine protein,urine C3,urine retinol-binding protein,urine lysozyme,urine N-ace-tyl-β-glucosaminidase level .Conclusion This study has provided another evidence for the involvement of mast cells in renal injury un -der the condition of diabetic nephropathy .Mast cells and chymase may have important roles in the development of diabetic nephropathy and might be a novel target for treatment of the disease .

关 键 词：糜蛋白酶 肥大细胞 糖尿病肾病 病理意义 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]