肾小球滤过率与血清VEGF、胆红素水平在糖尿病肾病中的关系研究  

Study on the Relationship Between Glomerular Filtration Rate and Serum Levels of VEGF and Bilirubin in Diabetic Kidney Disease

作　　者：廖涛生 冯涛[2] 刘炳贤 敬春兰 

机构地区：[1]甘孜藏族自治州人民医院内三科,四川甘孜626000 [2]包头医学院第二附属医院肾内科,内蒙古包头014030 [3]苍溪县人民医院肾内科,四川广元628400 [4]资阳市人民医院内分泌科,四川资阳641300

出　　处：《标记免疫分析与临床》2017年第11期1263-1268,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的研究糖尿病肾病(DKD)患者肾小球滤过率(e GFR)与血清血管内皮生长因子(VEGF)、胆红素水平的关系。方法选取2016年1月至2017年2月我院收治的DKD患者90例为研究对象(DKD组),按照e GFR水平分为A1组:<60m L/[min·(1.73m2)],A2组60m L/[min·(1.73m2)]≤e GFR<90m L/[min·(1.73m2)],A3组:e GFR≥90m L/[min·(1.73m2)],另选取单纯糖尿病(DM)及健康志愿者各50例,分别纳入DM组和健康组,比较DKD组、DM组、健康组e GFR、血清白蛋白(ALB)、尿酸(UA)、血肌酐(SCr)、总胆红素(TBIL)、直接胆红素(DBIL)、VEGF及总胆固醇(TC)、甘油三酯(TG)水平,同时对比A1、A2、A3组病程及上述指标,分析e GFR与其他生化指标的相关性,评价e GFR、VEGF、胆红素诊断DKD的效能,并分析DKD患者中影响e GFR水平的独立危险因素。结果 DKD组血清e GFR(70.18±20.56)m L/[min·(1.73m2)]、ALB(35.29±10.67)g/L、TBIL(9.18±2.65)μmol/L、DBIL(2.17±0.45)μmol/L较DM组及健康组低,DKD组UA(401.23±10.09)μmol/L、SCr(1.29±0.67)mg/d L、VEGF(55.29±1.25)pg/m L、TC(6.30±2.12)mmol/L、TG(2.79±1.36)mmol/L显著高于DM组及健康组(P<0.05);A1组病程长于A2、A3组,A1组血清ALB、SCr、TBIL、DBIL低于A2、A3组,A1组UA、VEGF、TC、TG较A2、A3组高(P<0.05);相关分析显示DKD患者e GFR与TBIL、DBIL呈正相关(P<0.05),与SCr、VEGF、TC、TG呈负相关(P<0.05);e GFR、VEGF、胆红素联合诊断DKD的灵敏度、准确度、特异性高于单项指标诊断;Logistic回归分析显示病程、血清VGEGF、TG、TBIL是影响DKD患者e GFR的独立危险因素(P<0.05)。结论糖尿病肾病患者e GFR与其血清VEGF、胆红素水平密切相关,临床可综合上述指标进行诊断。Objective To study the relationship between glomerular filtration rate （eGFR）, serum levels of vascular endothelial growth factor（VEGF） and bilirubin in diabetic kidney disease（DKD）. Methods 90 cases of patients with DKD treated in our hospital from January 2016 to February 2017 were selected as the study subjects（ DKD group）. According to the eGFR level, they were divided into A1 groups [eGFR level 〈 60 mL/[min · （ 1. 73m^2 ）]] , A2 group [60 mL/I min · （ 1. 73m^2 ）] ≤ eGFR level 〈 90 mL/[ min · （ 1.73m^2 ） ] ] and A3 group E eGFR level I〉 90 mL/[ min · （ 1.73m^2 ）]]. Another 50 cases with simple diabetes mellitus（DM） and 50 healthy volunteers were included into the DM group and the healthy group,respectively. The eGFR, serum albumin （ ALB ）, uric acid （ UA ）, total bilirubin （ TBIL ）, direct bilirubin （DBIL）, VEGF,total cholesterol（TC） and triglyceride（TG） levels were compared among DKD group, DM group and healthy group. The course of disease and the above indicators were compared among A1 group, A2 group and A3 group. The relationship between eGFR and other biochemical indicators was analyzed, the efficiencies of eGFR, VEGF and TBIL in the diagnosis of DKD were evaluated, and the independent risk factors influencing eGFR in patients with DKD were also analyzed. Results The serum levels of eGFR, ALB, TBILandDBILintheDKD group [（70. 18±20.56） mL/[min · （1.73m^2）1,（35.29 ±10.67）g/L, （9.18 ± 2.65 ）μmol/L and（ 2.17 ± 0.45 ）ixmol/L l were lower than those in DM group and healthy group, while levels of UA, SCr, VEGF, TC and TG [ （401.23 ± 10.09 ） μmol/L, （ 1.29 ± 0.67 ） mg/dL, （ 55.29 ± 1.25 ） pg/mL, （6.30 ± 2. 12 ） mmol/L and （ 2.79 ± 1.36 ） mmol/L 1 were significantly higher than those in DM group and healthy group（ P 〈 0.05 ）. The course of disease in A1 group was longer than that in A2 group and A3 group. Levels of serum ALB, SCr, TBIL and DBIL were lower in A1 group than A2 group and

关 键 词：糖尿病肾病 肾小球滤过率 VEGF 胆红素 关系 

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