2型糖尿病患者尿中血管内皮生长因子变化及其意义

The changes of urinary vascular endothelial growth factor and their clinical significance in type 2 diabetes

目的了解2型糖尿病患者尿中血管内皮生长因子(VEGF)的改变,探讨检测VEGF在早期诊断糖尿病肾病和评价糖尿病肾病进展中的价值。方法根据24h尿白蛋白排泄率(UAER)将68例2型糖尿病患者分为3组:正常蛋白尿组、微量蛋白尿组和临床蛋白尿组。采用ELISA等方法检测尿中VEGF、尿白蛋白(ALB)、尿视黄醇结合蛋白(RBP)等指标。结果与正常对照组比较,糖尿病各组尿VEGF水平明显增高(P值均<0.05)。尿VEGF在微量蛋白尿组较正常蛋白尿组增高,临床蛋白尿组最高,糖尿病3组间尿VEGF比较差异有显著性(P值均<0.05)。尿VEGF水平与尿白蛋白、尿视黄醇结合蛋白均呈显著正相关。结论糖尿病患者尿VEGF水平异常增高,检测尿VEGF的变化可能对监测肾病进展有重要意义。VEGF增高可能也反映糖尿病肾小管-间质病变。

Objective To investigate the clinical value of vascular endothelial factor （VEGF） in the early diagnosis and severity assessment of diabetic nephropathy. Methods Using ELISA method, urinary VEGF level was detected in 68 patients with type 2 diabetes and 27 controls. Urinary retinal-binding protein （URBP） , urinary albumnin （UALB） were also measured simultaneously. Results Urinary VEGF level significantly increased in diabetic patients compared with that in controls （ P 〈 0. 05, respectively） and further rose as the nephropathy progressed. Urinary VEGF level was highly correlated （ r = 0. 249,P 〈 0. 05 ） with URBP which was higher significantly than that in controls（ P 〈 0.01 ） . A positve correlation was also found between urinary VEGF and UALB （ r = 0. 660, P 〈 0.01 ）. Conclusion VEGF might be an early marker for predicting diabetic nephropathy and assessing its severity.