糖尿病肾脏病肾精亏虚证中尿ERdj3和Nephrin表达研究  

Expression of urine ERdj3 and Nephrin in diabetes kidney disease with kidney essence deficiency syndrome

作　　者：周盈 史扬 谢惠迪 郑毅成 高飞 王健[2] 张先慧[2] 柳红芳[2] ZHOU Ying;SHI Yang;XIE Huidi;ZHENG Yicheng;GAO Fei;WANG Jian;ZHANG Xianhui;LIU Hongfang(Beijing Puren Hospital,Beijing 100062,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;State Key Laboratory of Kidney Diseases of First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Beijing Chaoyang District Hospital of Traditional Chinese Medicine,Beijing 100020,China)

机构地区：[1]北京市普仁医院,北京100062 [2]北京中医药大学东直门医院,北京100700 [3]解放军总医院第一医学中心肾脏病全国重点实验室,北京100853 [4]北京市朝阳区中医医院,北京100020

出　　处：《现代中西医结合杂志》2024年第16期2212-2216,2249,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金青年科学基金项目(8200151229);北京中医药大学东直门医院2022年度科技创新专项(DZMKJCX-2022-003)。

摘　　要：目的探究糖尿病肾脏病(DKD)患者肾小球足细胞是否存在内质网应激,分析患者尿液中内质网定位Dna J家族成员3(ERdj3)和足细胞保护标志蛋白(Nephrin)与中医证型、蛋白尿和肾功能的相关性。方法以2020年9月—2023年6月北京中医药大学东直门医院东城区、通州院区诊治且基线匹配的56例2型糖尿病(T2DM组)和45例糖尿病肾脏病(DKD组)患者为研究对象,其中DKD组患者再分为DKD肾精亏虚组和DKD非肾精亏虚组。比较T2DM组和DKD组、DKD非肾精亏虚组和DKD肾精亏虚组间ERdj3、Nephrin水平;分析DKD组患者ERdj3、Nephrin水平与中医肾精亏虚证积分、兼夹实证证素积分、24h尿蛋白定量、血肌酐(SCr)、估算肾小球滤过率(eGFR)的相关性。结果DKD组患者尿ERdj3、Nephrin水平均明显高于T2DM组(P均<0.05);DKD肾精亏虚组患者尿ERdj3、Nephrin水平均明显高于DKD非肾精亏虚组(P均<0.05)。尿ERdj3水平与DKD精亏证、气滞证、血瘀证、痰浊证积分和24 h尿蛋白定量均呈正相关(P均<0.05),尿Nephrin水平与DKD精亏证、水湿证、血瘀证积分和24 h尿蛋白定量均呈正相关(P均<0.05)。结论DKD患者存在尿ERdj3、Nephrin高表达,且二者表达水平均与精亏证积分呈正相关,有望为寻找DKD肾精亏虚证及相关兼夹实证可能的分子标记物提供客观依据。Objective It is to explore whether endoplasmic reticulum stress exists in glomerulus podocytes of patients with diabetes kidney disease(DKD),and to analyze the correlations of urinary ER-localized DnaJ family member 3(ERdj3)and Nephrin with traditional Chinese medicine syndrome types,proteinuria,and renal function.Methods Fifty-six patients with type 2 diabetes mellitus(T2DM group)and 45 patients with diabetic kidney disease(DKD group)who were diagnosed and treated in Dongcheng Branch and Tongzhou Branch of Dongzhimen Hospital of Beijing University of Chinese Medicine and matched at baseline from September 2020 to June 2023 were used as the study subjects,in which the patients in the DKD group were subdivided into DKD with kidney essence deficiency syndrome group and DKD without kidney essence deficiency syndrome group.The levels of ERdj3 and Nephrin levels were compared between T2DM group and DKD group,and between DKD with kidney essence deficiency syndrome group and DKD without kidney essence deficiency syndrome group;the correlations of the levels of ERdj3 and Nephrin with the scores of kidney essence deficiency syndrome,scores of complicating excess syndrome,24 h urine protein quantification,blood creatinine(SCr),estimated glomerular filtration rate(eGFR)were analyzed in the patients of DKD group.Results The levels of urinary ERdj3 and Nephrin in the patients of the DKD group were significantly higher than those in the T2DM group(all P<0.05),and the levels of urinary ERdj3 and Nephrin in the patients of the DKD with kidney essence deficiency syndrome group were significantly higher than those in the DKD without kidney essence deficiency syndrome group(all P<0.05).The level of urinary ERdj3 was positively correlated with the scores of DKD with kidney essence deficiency syndrome,Qi stagnation syndrome,blood stasis syndrome,phlegm-turbidity syndrome and 24 h urine protein quantification(all P<0.05),and the level of urinary Nephrin was positively correlated with the scores of DKD essence deficiency syndrome,water

关 键 词：糖尿病肾脏病 肾精亏虚证 内质网应激 内质网定位Dna J家族成员3 足细胞保护标志蛋白 

分 类 号：R587.2[医药卫生—内分泌]