糖尿病肾病患者尿中结缔组织生长因子的检测及意义

Urinary Excretion Rate of Connective Tissue Growth Factor in Diabetic Patients and its Clinical Significance

目的探讨糖尿病患者尿中结缔组织生长因子(CTGF)浓度的变化及其意义。方法将60例糖尿病患者根据尿白蛋白排泄率(UAER)分为正常白蛋白尿组(组)、微量白蛋白尿组(组)和大量白蛋白尿组(组),分别检测各组患者尿CTGF及临床生化指标,并与20例对照组(NC组)进行比较。结果糖尿病各组患者尿中CTGF含量显著高于对照组(P<0.05),且随着UAER增加其水平亦呈递增趋势,组间比较差异有显著性(P<0.01)。相关分析表明,尿CTGF与UAER及视黄醇结合蛋白排泄率呈显著正相关(P<0.01),与内生肌酐清除率(Ccr)成负相关。结论肾脏CTGF蛋白表达的上调可能是糖尿病肾病的发生机制之一,尿CTGF排泄率可以作为诊断早期糖尿病肾病和评价病变程度的标志物之一。

Objective To investigate the urinary excretion rate of connective tissue growth factor （CTGF） in diabetic patients and its clinical significance. Methods Sixty patients with diabetes were divided into three groups according to urinary albumin excretion rate （UAER） ：normal albuminurie group （A） （〈20μg/min,n= 20） ,mieroalbuminurie group （B） （20～200μg/min,n=20） and maeroalbuminurie group （C） （〉200μg/min,n=20）. The urinary CTGF was determined by ELISA. Results The excretion rate of the urinary CTGF in diabetic patients was markedly higher than that in healthy controls （P〈0.05） ,moreover ,the excretion rate of urinary CTGF was increased with UAER and there were significant differenees among the three groups （P〈0.01）. Urinary CTGF excretion was also positively correlated with UAER and RBP, negatively correlated with ereatinine clearance rate （Cer）. Conclusion The overexpression of CTGF protein in renal cortex of diabetic rats may be one of the mechanisms of diabetic nephropathy;the urinay excretion rate of CTGF might be one early marker for predicting diabetic nephropathy and assessing its severity.