糖尿病患者层粘连蛋白水平监测及临床意义

The Monitoring and Clinical Significance of the Level of Laminin in Diabetes Mellitus

目的 探讨糖尿病患者层粘连蛋白 (Laminin ,LN)水平与糖尿病肾病的关系。方法 采用放射免疫法 (RIA)测定 75例糖尿病患者和 4 2例正常人血清及尿液中LN的水平 ,99Tcm DTPA肾动态显像方法进行肾小球滤过率的检测。结果 ①糖尿病肾病组血清、尿液LN水平明显高于糖尿病无肾病组 (P <0 .0 5 )及对照组 (P<0 .0 1) ,糖尿病组无肾病组血清、尿液LN水平高于对照组 (P <0 .0 5 ) ;糖尿病肾病组GFR明显低于糖尿病无肾病组 (P <0 .0 5 )及对照组 (P <0 .0 1) ;总糖尿病组血清、尿液LN水平均显著高于对照组 (P <0 .0 5 ) ,而GFR低于对照组 (P <0 .0 5 )。②病程 <1年者其GFR高于对照组 (P <0 .0 5 ) ,病程 >10年者低于对照组 (P <0 .0 5 ) ;③糖尿病患者血清、尿液LN水平与GFR均呈显著负相关 ,r分别为 - 0 .6 2和 - 0 .5 2 (P <0 .0 1)。结论 LN在糖尿病肾病微血管病变机制中起着重要的作用 。

Objective To observe the relationship between laminin and diabetic nephropathy.Methods The level of serum and urinary laminin was measured with radioimmunoassay and the GFR with 99 Tcm diethylenetriamine pentaacetic acid ( 99 Tcm-DTPA)-renal dynamic imaging in 75 diabetes mellitus and 42 normal subjects.Results ①The level of serum LN(136.30±11.20 μg/L) and urinary LN (31.76±5.77μg/L) in diabetic nephropathy group was significantly higher than that in diabetes without nephrosis(P<0.05)and the control(P<0.01),and the level of serum LN(126.54±6.98μg/L) and urinary LN(26.27±3.81μg/L)in diabetes without nephrosis was significantly higher than that in the control(P<0.05);the GFR of diabetic nephropathy group(78.84±10.79μg/L) was significantly lower than that in diabetes without nephrosis(P<0.05)and the control(P<0.01);the level of serum LN (131.49±10.74μg/L) and urinary LN (29.05±5.60μg/L) in all the diabetes mellitus groups was significantly higher than that in the control(P<0.05),whereas the GFR was sinificantly lower than that in control group(P<0.05).②The value of GFR in the group of diabetes mellitus lasting less than 1 year was higher than that of control group(P<0.05),but inverse in more than 10 years(P<0.05).③The level of serum and urinary LN had sinificantly negative correlation with the GFR(P<0.01).Conclusion LN may be an important factor in microangiopathy of diabetic nephropathy.It may be an important indicator in the diagnosis of the early diabetic nephropathy.