2型糖尿病肾脏疾病患者血清同型半胱氨酸及炎性因子水平的分析  

Analysis of homocysteine and inflammatory factor levels in patients with type 2 diabetes and diabetic kidney disease

作　　者：刘辉 马亮[2] 刘倩[1,2] 孔晓牧[2] 魏先森[3] 徐英春[1] LIU Hui;MA Liang;LIU Qiang(Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academic Medical Science and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院检验科,北京100730 [2]中日友好医院检验科,北京100029 [3]中日友好医院肾内科,北京100029

出　　处：《中日友好医院学报》2021年第5期273-275,283,共4页Journal of China-Japan Friendship Hospital

基　　金：国家自然科学基金面上项目(82074221);北京临床重点专科项目(2020年度)。

摘　　要：目的:探讨2型糖尿病(T2DM)患者血清同型半胱氨酸(HCY)及炎性因子水平与糖尿病肾脏疾病(DKD)发生发展的相关性。方法:选取2019年2月~2020年4月中日友好医院内分泌科和肾内科住院的T2DM患者304例,分为单纯T2DM组(147例)和DKD组(157例)。采用化学发光法检测肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6),采用循环酶法检测HCY,进行组间比较。DKD患者分为微量蛋白尿组和大量蛋白尿组进行亚组分析。结果:DKD组HCY、TNF-α、IL-6水平显著高于T2DM组(均P<0.05)。大量蛋白尿亚组的HCY、TNF-α、IL-6水平显著高于微量蛋白尿亚组(均P<0.05)。HCY、TNF-α、IL-6与尿微量白蛋白/肌酐比值(UACR)正相关,与肾小球滤过率(eGFR)负相关(P<0.05)。结论:DKD患者血清HCY、TNF-α、IL-6水平与DKD的发生和发展存在相关性,提示检测HCY、TNF-α、IL-6水平对评估DKD的发病风险和病情进展具有重要意义。Objective:To investigate the relationship between serum homocysteine(HCY)and inflammatory factor levels in patients with type 2 diabetes(T2 DM)and diabetic kidney disease(DKD).Methods:From February2019 to April 2020,304 inpatients in the Endocrinology and Nephrology Department of China-Japan Friendship Hospital with T2 DM were enrolled.There were 147 cases in the T2 DM alone group and 157 cases in the DKD group.Chemiluminescence method was used to detect serum inflammatory factors:tumor necrosis factor-α(TNF-α)and interleukin 6(IL-6).Cycle enzyme method was used to detect the HCY level,the results of the two groups were compared.The DKD components were divided into microalbuminuria group and macroalbuminuria group for subgroup analysis.Results:The levels of HCY,TNF-α and IL-6 in the DKD group were significantly higher than those in the T2 DM group(P<0.05).In the DKD group,the levels of HCY,TNF-α and IL-6 in the macroalbuminuria group were significantly higher than those in the microalbuminuria group(P<0.05).HCY,TNF-α,IL-6 were positively correlated with UACR and negatively correlated with eGFR(P<0.05).Conclusion:The serum levels of HCY,TNF-α and IL-6 in DKD patients are correlated with the occurrence and development of DKD,suggesting the significance of HCY,TNF-α, and IL-6 in assessing the risk and progression of DKD.

关 键 词：糖尿病肾脏疾病 同型半胱氨酸 肿瘤坏死因子Α 白细胞介素-6 

分 类 号：R446.62[医药卫生—诊断学]