2型糖尿病肾病患者血清TBIL、SOD、TNF-α水平分析  

The analysis of serum TBIL,SOD and TNF-αlevels in patients with type 2 diabetic nephropathy

作　　者：张斌[1] 张珏[1] 孟佳丽[1] 陈建中[1] ZHANG Bin ZHANG Jue Meng JiaLi CHEN J ianzhong(Department of Clinical Laboratory, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China)

机构地区：[1]上海中医药大学附属曙光医院检验科,201203

出　　处：《检验医学与临床》2016年第19期2738-2740,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨2型糖尿病肾病(DN)患者血清总胆红素(TBIL)、血清超氧化物歧化酶(SOD)、肿瘤坏死因子-α(TNF-α)水平的变化及临床意义。方法 123例2型糖尿病(T2DM)患者依据尿清蛋白/肌酐比值(UACR)分成3组:正常清蛋白尿(NA)组40例,微量清蛋白尿(MA)组40例,大量清蛋白尿(OA)组43例,另选择42例体检健康者为对照(NC)组,检测血清TBIL、SOD、TNF-α水平,分析TBIL、SOD、TNF-α与UACR的相关性。采用多元逐步回归法分析UACR的主要影响因素。结果在NC组、NA组、MA组、OA组,TBIL、SOD依次降低,OA组TBIL、SOD水平明显低于其他3组(P<0.05),但其他3组间TBIL、SOD水平比较,差异无统计学意义(P>0.05);TNF-α水平依次升高,OA组TNF-α水平明显高于其他3组(P<0.05),MA组和NA组TNF-α水平明显高于NC组(P<0.05),但MA组与NA组比较,差异无统计学意义(P>0.05);Spearman相关性分析显示,DN患者UACR与TBIL、SOD水平呈负相关,与TNF-α水平呈正相关。血清TBIL与SOD呈正相关,与TNF-α呈负相关,SOD与TNF-α呈负相关(P<0.05);多元逐步回归分析表明,TBIL(β=-0.068,P=0.001),SOD(β=-0.012,P=0.000),TNF-α(β=-0.018,P=0.002)是UACR的独立危险因素。结论 DN患者早期即存在微炎性反应,在OA组更伴有氧化应激反应,氧化应激与微炎症互相促进,与肾功能损伤形成恶性循环。Objective To investigate the changes and clinical significance of serum total bilirubin（TBIL）,superoxide dismutase（SOD）and tumor necrosis factor-α（TNF-α）in patients with type 2diabetic nephropathy（DN）.Methods A total of 123 type 2diabetes mellitus（T2DM）patients were recruited and 42 healthy individuals as normal controls（group NC）in this study.According to urinary albumin to creatinine ratio（UACR）,the patients were divided into 3groups,40 patients with normal albuminuria（group NA）,40 patients with microalbuminuria（group MA）and 43 patients with over-albuminuria（group OA）.Serum TBIL,SOD and TNF-αlevels were measured and analyzed.The association of UACR and TBIL,SOD and TNF-αwere analyzed in 123T2 DM patients.The influencing factors of UACR were investigated by multiple stepwise regression analysis.Results The serum levels of TBIL,SOD increased progressively and TNF-αdecreased progressively from groups NC,NA,MA to OA.The serum level of TBIL and SOD were significant lower in group OA than in other three groups（P〉0.05）.However,there were no significant difference on TBIL and SOD among other three groups（P〉0.05）.Meanwhile,the serum level of TNF-αin group OA was significant higher than those in other three groups（P〈0.05）.However,there was no significant difference on TNF-αbetween group MA and group NA（P〉0.05）.Spearman correlation analysis showed that UACR was positively associated with TBIL and SOD,and negatively associated with TNF-αin DN patients.Meanwhile,TBIL was positively associated with SOD,and negatively associated with TNF-α（P=0.001）;SOD was negatively associated with TNF-α.Multiple stepwise regression analysis indicated that TBIL（β=-0.068,P〈0.001）,SOD（β=-0.012,P=0.000）and TNF-α（β=-0.018,P=0.002）were independent influencing factors for UACR.Conclusion Micro-inflammation existed in the early phase of DN patients and there is even oxidative stress status in OA group.Along with impairment of renal function,oxidative str

关 键 词：糖尿病肾病 尿清蛋白/肌酐比值 氧化应激 微炎症 

分 类 号：R654.2[医药卫生—外科学]