血清肿瘤坏死因子-α与糖尿病肾病的相关性研究

Study of the relationship between the tumor necrosis factor-α and diabetic nephropathy

目的探讨2型糖尿病(DM)患者血清肿瘤坏死因子-α(TNF-α)的变化规律及其在糖尿病肾病(DN)发病中的作用。方法采用放射免疫法测定76例2型CM患者与40例正常人TNF-α的浓度,各组间采用Student—t检验进行比较,应用单因素直线相关分析及多因素Cox模型进行相关性研究。结果(1)不同时期DM患者TNF-α都较对照组显著升高(P<0.001)。(2)单因素分析示: TNF-α与尿白蛋白排泄率(UAER)呈正相关(P<0.01)。(3)Cox模型分析示:TNF-α、NO、NO/ET 及体重指数(BMI)、吸烟、舒张压(DBP)、文化程度为DN发病的独立危险因素。结论2型糖尿病患者血TNF-α浓度的异常改变,成为影响DN发生发展的独立危险因素之一。

Objective To investigate the effect of the tumor necrosis factor-α （TNF-α） on the pathogenesis and progress of diabetic nephropathy（DN）. Methods The circulation level of TNF-α were measured in 40 normal subjects and 76 cases of type 2 diabetes mellitus by radioimmunoassay （RIA）. The student-t test, univariate and multivariate analyses were implemented to study the relationship between the TNF-α and DN. Results （1） Compared with normal control （NC）, Serum TNF-α concentration in normolalbuminuria （NA）, microalbuminuria （MI） and macroallbuminuria （MA） group were markedly elevated than that of NC（P〈0. 001）. （2） There was a significant positive relationship between TNF-α level and urinary albumin excretion rate level. （3） Multivariate analysis by Cox model showed that TNF-α was one of the important risk factor in the pathogenesis and progress of DN（P〈0.05）, along with NO,NO/ET value , BMI, cigarette, diastolic BP（DBP） and the extent of educated. Conclusion The disorder of the TNF-α can promote the pathogenesis and development of DN. The levels of TNF-α was one of the important risk factor in pathogenesis and progress of DN.