糖尿病肾病患者自身抗体检测的意义  

Significance of autoantibody detection in patients of diabetic nephropathy

作　　者：杨宏秀[1] 张会芬[1] 刘丽[1] 袁宝军[1] 夏彦东 王建梅 Hong-xiu Yang;Hui-fen Zhang;Li Liu;Bao-jun Yuan;Yan-dong Xia;Jian-mei Wang(Department of Clinical Laboratory,Kailuan General Hospital,Tangshan,Hebei 063000,China;Department of Obstetrics and Gynecology,Kailuan General Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]开滦总医院检验科,河北唐山063000 [2]开滦总医院妇产科,河北唐山063000

出　　处：《中国现代医学杂志》2019年第5期108-111,共4页China Journal of Modern Medicine

摘　　要：目的探讨糖尿病肾病(DN)患者抗肾小球基底膜抗体(anti-GBM antibody)、抗心磷脂抗体(ACA)、尿酸(UA)和同型半胱氨酸(Hcy)检测的意义,为DN的诊断和治疗提供依据。方法收集174例2型糖尿病(T2DM)患者的血清,依据肾小球滤过率(GFR)和尿蛋白/肌酐比值(ACR)分为单纯糖尿病组(A组)、早期糖尿病肾病组(B组)、临床肾病组(C组)和肾功能不全组(D组)。采用间接酶联免疫法检测GBM和ACA,酶法检测UA和Hcy。结果进行统计学分析。结果 B组UA、Hcy和抗心磷脂抗体免疫球蛋白M(ACAIgM)水平高于A组,C组和D组UA、Hcy、GBM、抗心磷脂抗体免疫球蛋白G(ACA-Ig G)和抗心磷脂抗体免疫球蛋白A(ACA-IgA)水平高于A组,差异有统计学意义(P <0.05);C组UA和Hcy水平高于B组,D组UA、Hcy、GBM和ACA-IgA水平也高于B组,差异有统计学意义(P <0.05);D组UA、Hcy和GBM水平高于C组,差异有统计学意义(P <0.05)。GBM、ACA-IgA、UA和Hcy分别与ACR呈正相关(r=0.281、0.206、0.411和0.492,P <0.05),ACA-Ig G和ACA-IgM与ACR无相关性。结论血清UA、Hcy和ACA-IgM水平可提示早期肾损害,血清GBM、ACA、UA和Hcy可作为DN疾病进程的监测指标。Objective To investigate the significance of anti-glomerular basement membrane(anti-GBM),anti-cardiolipin antibodies(ACA),uric acid(UA)and homocysteine(Hcy)in patients with diabetic nephropathy(DN),and provide a basis for the diagnosis and treatment of DN.Methods Totally 174 patients with type 2 diabetes mellitus(T2DM)were divided into four groups according to estimated Glomerular Filtration Rate(GFR)and anurinary albumin to creatinine ratio(ACR):diabetic mellitus group(A group),early diabetic nephropathy group(B group),clinic diabetic nephropathy group(C group)and renal insufficiency group(D group).GBM and ACA were detected by indirect enzyme-linked immunosorbent assay,and UA and Hcy were detected by enzymatic method.The results were statistically analyzed.Results Compared with A group,UA,Hcy and anti-cardiolipin antibodies immune globulin M(ACA-IgM)levels in B group were increased,and levels of UA,Hcy,GBM,anti-cardiolipin antibodies immune globulin G(ACA-IgG)and anti-cardiolipin antibodies immune globulin A(ACA-IgA)in C group and D group were higher than those in A group,the differences were statistically significant(P<0.05).Compared with B group,levels of UA and Hcy in C group were increased,and levels of UA,Hcy,GBM and ACA-IgA in D group were also increased,the differences were statistically significant(P<0.05).Compared with C group,UA,Hcy and GBM levels in D group were increased,the differences were statistically significant(P<0.05).ACR was negatively correlated with GBM,ACA-IgA,UA and Hcy(r=0.281,0.206,0.411 and 0.492,P<0.05),but not correlated with ACA-IgG and ACA-IgM.Conclusions Serum levels of UA,Hcy and ACA-IgM may indicate early renal damage.Serum GBM,ACA,UA and Hcy may be used as monitoring indicators for DN disease progression.

关 键 词：糖尿病肾病 抗肾小球基底膜抗体/抗体 抗心磷脂抗体/抗体 尿酸 同型半胱氨酸/高半胱氨酸 

分 类 号：R587.1[医药卫生—内分泌]