肾虚型糖尿病肾病与血管紧张素Ⅰ转换酶活性的关系(英文)

Relationship between the activity of serumal angiotensin I-converting enzyme and diabetic nephropathy of kidney deficiency

背景:糖尿病肾病(diabeticnephropathy,DN)与血管紧张素Ⅰ转换酶(angiotensinI-convertingenzyme,ACE)基因多态性关系密切,血清ACE活性增高是DN发生发展的危险因素。然而ACE是否与DN肾虚证的发生有关目前尚未清楚。目的:探讨DN肾虚证与血清ACE活性的关系。设计:以诊断为依据的病例对照研究。地点、对象和方法:选择解放军第一军医大学南方医院内分泌科确诊为DN的住院87例患者为研究对象。依据肾虚证诊断标准对患者进行中医辨证,分为肾气虚组(26例)、肾阴虚组(20例)、肾阳虚组(18例)以及对照组(非肾虚患者,23例)。对所有受试者进行ACE活性测定主要观察指标各组DN患者血清ACE活性比较。结果:非肾虚组、肾气虚组、肾阴虚组和肾阳虚组DN患者血清ACE活性分别为(413±112),(492±142),(632±153),(654±125)nkat。非肾虚组与其他3组比较,差异有显著性意义(P<0.05),肾阴虚组、肾阳虚组与其他两组比较,差异有显著性意义(P<0.01)。肾阴虚组、肾阳虚组比较,差异无显著性意义(P>0.05)。结论:DN患者血清ACE活性与肾虚证的发生发展密切相关,血清ACE活性可能是DN容易发生肾虚证的物质基础。

BACKGROUND:There is a close relationship between diabetic nephropathy(DN) and gene polymorphism of angiotensin I converting enzyme gene(ACE),and the increase of serumal ACE activity is a risk factor of DN.However,so far the role of ACE in kidney deficiency of diabetic nephropathy is unclear. OBJECTIVE:To investigate the relationship between the activity of serumal ACE and kidney deficiency of DN. DESIGN:A case controlled study based on diagnosis was carried out. SETTING and PARTICIPANTS:Patients with DN were recruited from the Department of Endocrinology of Nanfang Hospital, First Military Medical University of Chinese PLA. INTERVENTIONS:A total of 87 patients with DN were divided into four groups according to diaganostic standard of kidney deficiency:23 non kidney deficiency,26 kidney qi deficiency,20 kidney yin deficiency and 18 kidney yang deficiency. MAIN OUTCOME MEASURES:Serumal ACE activity of the patients was detected with spectrophotometry. RESULTS:Serumal ACE activity of the patients with non kidney deficiency,kidney qi deficiency,kidney yin deficiency and kidney yang deficiency were(413±112),(492±142),(632±153) and(654±125) nkatal,respectively.ACE activity in non kidney deficiency group was significantly lower than that in other groups(P< 0.05);ACE activity in kidney yin deficiency group and in kidney yang deficiency group were markedly higher than that in other groups(P< 0.01),but there was no difference between kidney yin deficiency group and kidney yang deficiency group(P >0.05). CONCLUSION:It is suggested that there is a close relationship between serumal ACE activity and the occurrence and development of kidney deficiency in patients with DN,which may be its material foundation.