气阴两虚型2型糖尿病早期肾损害CysC与炎症因子的相关性  

The Relativity between CysC of Early Renal Damage of Type Two Diabetes Mellitus of Qi-Yin Dual Deficiency Pattern and Inflammatory Factors

作　　者：程涛[1] 李雪英 杨丽霞[1] 张佳红[3] 张玉梅 姜良恩 党会芬 李建省[6] 刘铜华[7] CHENG Tao;LI Xueying;YANG Lixia;ZHANG Jiahong;ZHANG Yumei;JIANG Liang＇en;DANG Huifen;LI Jiansheng;LIU Tonghua(Gansu Provincial Academy of Chinese Medicine,Lanzhou 730050,China;Xingtai Municipality TCM Hospita;Gansu Province People hospital;Xigu District People＇s Hospital of Lanzhou Municipality;Gansu University of Chinese Medicine;Gansu Provincial Hospital of Traditional Chinese Medicine;Beijing University of Chinese Medicine)

机构地区：[1]甘肃省中医药研究院,兰州730050 [2]邢台市中医院 [3]甘肃省人民医院 [4]兰州市西固区人民医院 [5]甘肃中医药大学 [6]甘肃省中医院 [7]北京中医药大学

出　　处：《西部中医药》2018年第6期1-6,共6页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号81560764);甘肃省中医药管理局科研课题(编号GZK-2015-32);甘肃中医药大学研究生创新基金资助项目(编号2015X13)

摘　　要：目的:探讨气阴两虚型2型糖尿病早期肾损害炎症因子单核细胞趋化因子1(MCP-1)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)的表达与胱抑素C(CysC)的相关性。方法:筛选出2型糖尿病早期肾损害患者气阴两虚证(NA组)40例,同时随机选取健康体检者40名为健康对照组(NC组)。应用酶联免疫法(ELISA)检测血清CysC、MCP-1、IL-6、TNF-α水平,测定2组空腹血糖(FPG)、餐后2小时血糖(2 hPG)、糖化血红蛋白(HbA1c)、肾功能及血脂。结果:与NC组相比,NA组的FPG、2 hPG、HbA1c、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)差异有统计学意义(P<0.05);2组相比,血尿素氮(BUN)与血清肌肝(Scr)差异无统计学意义(P>0.05);2组在CysC、IL-6、TNF-α、MCP-1水平上差别有统计学意义(P<0.05);在NA组中,血清胱抑素C(CysC)水平不仅与IL-6水平呈负相关(r=-0.514,P<0.01),还与FPG水平呈负相关(r=-0.324,P<0.05),TG水平与HDL-C水平呈负相关(r=-0.514,P<0.05),与FPG及HbA1c水平呈正相关(r=0.378,P<0.05)(r=0.511,P<0.01),2 hPG与FPG呈正相关(r=0.557,P<0.01);对NA组检测指标做多元回归分析,自变量IL-6有统计学意义(B=-0.006,P<0.05)。结论:CysC、IL-6、TNF-α、MCP-1在2型糖尿病早期肾损害气阴两虚型的发病中起着重要作用,IL-6与CysC可能存在因果关系,IL-6可能是气阴两虚型2型糖尿病早期肾损害的危险因素;血脂、血糖在气阴两虚型2型糖尿病早期肾损害的发病中起着重要作用。Objective：To discuss the relativity between cystatin C（CysC） and the expressions of monocyte chemotactic protein-1（MCP-1）, interleukin-6（IL-6） and tumor growth factor-α（TNF-α） of early renal damage of type two diabetes mellitus（T2DM） of Qi-Yin dual deficiency pattern. Methods：Forty T2DM patients（Na group） of Qi-Yin dual deficiency pattern suffering early renal damage were selected, simultaneously forty healthy persons who accepted physical examinations were chosen as healthy control group（NC group）. The levels of CysC, MCP-1, IL-6 and TNF-α in the serum were detected by using ELISA method, blood lipid, renal function, HbA1 c, 2 hPG and FPG of the patient were measured. Results：When the levels of FPG, 2 hPG, HbA1 c, TG, LDL-C and HDL-C of NA group were compared with these of NC group, the difference had statistical meaning（P〈0.05）; the difference had no statistical meaning in the comparisons of BUN and Scr between both groups（P〈0.05）; the difference showed statistical meaning in the comparisons of the levels of CysC, IL-6, TNF-α and MCP-1 between both groups（P〈0.05）; In NA group, the levels of CysC was not only negatively related to the levels of IL-6（r=-0.514, P〈0.01）, but also negatively related to the levels of FPG（r=-0.324, P〈0.05）, the level of TG was negatively related to the levels of HDL-C（r=-0.514,P〈0.05）, positively related to the levels of FPG and HbA1 c（r=0.378, P〈0.05）（r=0.511, P〈0.01）, 2 hPG was positively related to the levels of FPG（r=0.557, P〈0.01）; the detection indexes of NA groups were measured by using multiple regression analysis, there was statistical meaning for independent variable IL-6（B=-0.006, P〈0.05）.Conclusion：CysC, IL-6, TNF-α and MCP-1 are playing the important roles in the attack of early renal damage of T2DM of Qi-Yin dual deficiency pattern, IL-6 and CysC show causal relationship, IL-6 might be the risk factor of early renal damage of T2DM of Qi-Yin dual deficiency pattern; blood

关 键 词：糖尿病 2型 气阴两虚型 早期肾损害 CYSC 炎症因子 

分 类 号：R587.2[医药卫生—内分泌]