糖尿病肾病患者血清Ⅳ型胶原、层粘连蛋白水平变化及干预治疗观察

The changes of the serum of the type Ⅳ collagen and Laminin in diabetic nephropathies and the effect of interfered treatment

目的探讨血清Ⅳ型胶原(ⅣC)、层粘连蛋白(LN)与糖尿病肾病(DN)的相关性及血管紧张素转换酶抑制剂(ACEI)干预治疗对其影响。方法选择2型糖尿病(DM)患者166例及正常对照(NC)55例,根据尿白蛋白排泄率(UAER),将2型DM患者分为正常蛋白尿组(NA)、微量蛋白尿组(MA)、临床蛋白尿组(ODN),分别检测各组的血清ⅣC、LN,并观察干预治疗后上述指标的变化。结果2型DM患者血清ⅣC、LN水平高于NC组(P<001),DM患者从NA组、MA组到ODN组,血清ⅣC、LN逐渐增高,各组间差异有显著意义(P<001)。MA组和ODN组经干预治疗后,血清ⅣC、LN水平较前有显著性降低,UAER较前有显著性下降。结论血清ⅣC、LN水平变化与DN的发生发展密切相关,早期应用ACEI有助于防止或延缓DN的病理学进展。

Objective To investigate the relationship between diabetic nephropathy(DN),the serum level of type Ⅳ collagen(Ⅳ-C) and laminin(LN).The effect of interfered treatment of ACEI to DN was also studied.Methods As well as 55 healthy people were collected as the control group,166 cases of type-2 diabetes were collected as DM group and were divided into three groups according to the urinary albumin excretion rate(UAER).They are normal-album-urea(NA) group,micro-album-urea(MA) group and overt-diabetic-nephropathy(ODN) group.The serum level of Ⅳ-C & LN after and before interfered treatment of each case were detected and analyzed.Results The serum level of Ⅳ-C & LN of DM group was much higher than that of the control group(P<0.01).The level of Ⅳ-C & LN of ODN group was higher than that of the MA group,and that of the MA group was higher than that of the NA group,and the differences were significant(P<0.01).After the treatment of ACEI,the serum level of Ⅳ-C,LN and UAER of MA & ODN groups was significantly lower than that of before treatment.Conclusions The changes of serum level of Ⅳ-C & LN were closely correlated with DN.The application of ACEI in the early stage is helpful to prevent/postpone the progress of DN.