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机构地区:[1]首都医科大学附属北京同仁医院南区急诊科,北京市100176 [2]首都医科大学附属北京同仁医院综合内科,北京市100176
出 处:《中国全科医学》2014年第23期2711-2713,共3页Chinese General Practice
摘 要:目的:检测2型糖尿病(T2DM)肾病患者血浆人尾加压素Ⅱ(hU-Ⅱ)水平的变化,探讨hU-Ⅱ在糖尿病肾病进展过程中的临床意义。方法选取北京同仁医院南区综合内科2008年10月-2009年5月住院的T2DM患者66例,依据糖尿病肾病进展程度进行分组,比较各组血浆 hU -Ⅱ水平的变化。结果以尿清蛋白排泄率( UAER)分组,A组:UAER〈20μg/min,为尿蛋白正常;B组:UAER 20-200μg/min,为初期糖尿病肾病;C组:UAER〉200μg/min,为临床糖尿病肾病;C组患者血浆hU-Ⅱ水平〔(48.26±4.86) ng/L〕高于A、B组〔(27.26±4.58)、(34.83±4.82)ng/L〕,B组hU-Ⅱ水平高于A组,差异均有统计学意义(P〈0.05)。以肾小球滤过率( eGFR)分组,a组:eGFR〉80 ml/min,为肾功能正常;b组:eGFR 51-80 ml/min,为肾功能不全代偿期;c 组:eGFR 20-50 ml/min,为肾功能不全失代偿期;c 组患者血浆 hU -Ⅱ水平〔(48.95±7.43) ng/L〕高于 a、b 组〔(26.78±4.86)、(33.36±3.92)ng/L〕,b组hU-Ⅱ水平高于a组,差异均有统计学意义(P〈0.05)。T2DM患者血浆hU-Ⅱ水平与eGFR呈负相关(r=-0.737,P=0.000)。结论 hU-Ⅱ水平随着糖尿病肾病的加重而逐渐升高。联合测定糖尿病患者血浆hU-Ⅱ、UAER及eGFR水平有助于监测、判断糖尿病肾病的病程进展。Objective To detect the changes of human plasma urotensinⅡ( hU-Ⅱ)level in patients with diabetic nephropathy(DP),to explore its clinical role and significance in the progression of DP. Methods Sixty-six T2DM patients hospitalized in department of emergency,Beijing Tongren Hospital,from October 2008 to May 2009 were divided into 3 groups according to DP progression. The changes of hU-Ⅱlevel were compared in the 3 groups. ResUlts According to urinary albu-min excretion rate( UAER),the patients were divided into groups A( UAER〈20μg/min,normal),B( UAER 20-200μg/min,early DP),C( UAER〉200 μg/min,clinical DP). The plasma hU-Ⅱ level was higher in group C than in groups A, B〔(48. 26 ± 4. 86) ng/L,(27. 26 ± 4. 58) ng/L,(34. 83 ± 4. 82) ng/L〕,in group B than in group A,the difference was significant(P〈0. 05). According to glomerular filtration rate(eGFR),the patients were divided into groups a(eGFR〉80 ml/min,normal renal function),b( eGFR 51-80 ml/min,compensated stage of renal insufficiency),c( eGFR 20-50 ml/min,decompensated stage of renal insufficiency). The plasma hU-Ⅱlevel was higher in group c than in groups a,b〔(48. 95 ±7. 43)ng/L,(26. 78 ±4. 86)ng/L,(33. 36 ±3. 92)ng/L〕,in group b than in group a,the difference was significant (P〈0. 05). Plasma hU-Ⅱlevel was negatively correlated with eGFR(r= -0. 737,P=0. 000). ConclUsion hU-Ⅱin-creases with the aggravation of DP. Determination of hU-Ⅱ,UAER,eGFR levels helps monitor and judge DP progression.
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