糖尿病肾病患者治疗前后血清中抗AT1、α1、β1及M2受体水平变化及其临床意义  

Changes of Serum Levels of Anti-AT1,α1,β1 and M2 Receptors in Patients with Diabetic Nephropathy Before and After Treatment and Their Clinical Significances

作　　者：邓燕[1] 梁利波[1] 李俊梅[1] 王翠[2] 段勇 DENG Yan;LIANG Li-bo;LI Jun-mei;WANG Cui;DUAN Yong(Special Medical Center of West China Hospital,Sichuan University,Chengdu 610041,China;Department of Neurology,Chengdu Sixth People′s Hospital,Chengdu 610000,China;Department of Orthopaedics,Neijiang Hospital of Traditional Chinese Medicine,Neijiang 641099,China)

机构地区：[1]四川大学华西医院特需医疗中心,四川成都610041 [2]成都市第六人民医院神经内科,四川成都610000 [3]内江市中医院骨科,四川内江641099

出　　处：《标记免疫分析与临床》2019年第10期1714-1719,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨糖尿病肾病(DN)患者治疗前后血清中抗血管紧张素Ⅱ受体1型(AT 1-受体)、α1-肾上腺素受体(α1-受体)、β1肾上腺素受体(β1-受体)及M 2胆碱能受体(M 2-受体)水平变化及其临床意义。方法纳入DN患者115例(DN组)、2型糖尿病(T2DM)患者65例(T2DM组)和健康体检者46例(NC组),检测DN组、T2DM组治疗前及治疗8周后和NC组的相关实验室指标和自身抗体阳性率,分析两者相关性及不同疗效对自身抗体阳性率的影响,并将治疗前AT 1、α1、β1及M 2受体水平诊断DN做ROC曲线分析。结果治疗后,DN组、T2DM组的尿素氮(BUN)、肌酐(Scr)、尿白蛋白排泄率(Urea)值显著降低(P<0.05),肾小球过滤率(GFR)显著提高(P<0.05),差异均有统计学意义(P<0.05);治疗后,DN组AT 1、α1、β1及M 2受体阳性率显著降低(P<0.05),显著低于治疗前(P<0.05)、T2DM组治疗后(P<0.05)和NC组(P<0.05),差异有统计学意义(P<0.05);DN组患者中,AT 1受体、α1受体、β1受体、M 2受体与血BUN、血Scr、尿Urea呈显著正相关性(P<0.05),与GFR呈显著负相关性(P<0.05);DN治疗有效组的AT 1、α1、β1及M 2受体阳性率显著低于无效组(P<0.05);治疗前AT 1、α1、β1及M 2受体水平诊断DN做ROC曲线分析发现,四者受体和其联合诊断DN的曲线下的面积(AUC)分别为0.669、0.676、0.711、0.675和0.724,灵敏度分别为87.7%、90.8%、89.2%及92.3%和92.3%,特异性分别为53.9%、55.7%、47.0%及57.4%和50.4%。结论AT 1、α1、β1及M 2受体不仅可反映DN患者慢性肾功能不全情况,还可预测DN疗效,临床诊断价值确切。Objective To explore the changes and their clinical significances of serum levels of type 1 anti-angiotensin II receptor(AT 1-receptor),α1-adrenergic receptor(α1-receptor),β1 adrenergic receptor(β1-receptor)and M 2 cholinergic receptor(M 2-receptor)in patients with diabetic nephropathy(DN)before and after treatment.Methods 115 patients with DN(the DN group),65 patients with type 2 diabetes mellitus(T2DM)(the T2DM group)and 46 healthy examiners(the NC group)were enrolled in the study.The relevant laboratory indicators and auto-antibody positive rate were detected in the DN group and T2DM group before treatment and after 8 weeks of treatment and the NC group,and the correlation between them and effects of different efficacy on auto-antibody positive rate were analyzed.The levels of AT 1,α1,β1 and M 2 receptors before treatment in the diagnosis of DN were evaluated using ROC curve analysis.Results After treatment,the levels of urea nitrogen(BUN),creatinine(Scr)and urinary albumin excretion rate(Urea)in the DN group and T2DM group were significantly decreased(P<0.05),while glomerular filtration rate(GFR)was significantly increased(P<0.05),and there were significant differences among the three groups and between any two groups(P<0.05).After treatment,the positive rates of AT 1,α1,β1 and M 2 receptors were significantly decreased in the DN group(P<0.05),and were lower than those before treatment(P<0.05),in the T2DM group after treatment(P<0.05)and in the NC group(P<0.05),and there were statistically significant differences among the three groups after treatment(P<0.05).In the DN group,AT 1-receptor,α1 receptor,β1 receptor and M 2 receptor were significantly positively correlated with BUN,Scr and urine Urea(P<0.05)and were significantly negatively correlated with GFR(P<0.05).The positive rates of AT 1,α1,β1 and M 2 receptors in DN effective treatment group were significantly lower than those in ineffective treatment group.ROC curve analysis of AT 1,α1,β1 and M 2 receptors before treatment in diagnosing DN

关 键 词：糖尿病肾病 抗血管紧张素Ⅱ受体1型 Α1-肾上腺素受体 Β1肾上腺素受体 M 2胆碱能受体 

分 类 号：R58[医药卫生—内分泌]