炎症相关因子水平联检在2型糖尿病肾病患者中的临床意义

Clinical Significance of Combined Detection of Serum CRP,IL-6,IL-8 and TNF-α Levels for Diagnosis of Type 2 Diabetic Nephropathy

目的:探讨2型糖尿病肾病(diabetic nephropathy,DN)患者的血清C反应蛋白(CRP)、白细胞介素6(IL-6)、白细胞介素8(IL-8)和肿瘤坏死因子-α(TNF-α)水平的变化在肾病发生、发展中的作用。方法:将112例2型DN患者根据24h尿微量白蛋白排泄率(UAER)分为:无蛋白尿组(n=41)、微量蛋白尿组(n=37)和大量蛋白尿组(n=34)。观察患者CRP、IL-6、IL-8和TNF-α水平的改变,并与正常对照组(n=41)进行对比。结果:无蛋白尿组、微量蛋白尿组及大量蛋白尿组的CRP、IL-6、IL-8及TNF-α水平均明显高于正常对照组(P<0.01);微量蛋白尿组的CRP、IL-6、IL-8及TNF-α水平明显高于无蛋白尿组(P<0.01);大量蛋白尿组的CRP、IL-6、IL-8及TNF-α水平明显高于微量蛋白尿组(P<0.01)。结论:早期检测血清CRP、IL-6、IL-8及TNF-α水平的变化可以作为临床观察DN病情及判断DM预后的参考指标。

Objective To investigate the significance of changes of serum CRP, IL - 6, IL - 8 and TNF - α levels in the development of nephropathy in patients with type 2 diabetic nephrosis. Methods Serum CRP, IL - 6, IL - 8 and TNF - α levels were measured with RIA in 112 patients with DM2 and 30 controls. The 112 diabetic patients fell into three groups ： （1） Group A： without albuminuria （twine albumin excretion rate UAER 〈20μg/min, n =41）. Group B： micro-albuminuria UAER 〈200μg/min, n =37. Group C： macroalbuminuria UAER 〉200μg/min, n=34）. Results Serumlevels Of CRP, IL-6, IL-8 and TNFwere significantly higher in all the patients with type 2 diabetes than those in controls （P〈0.01）. Serum levels of CRP, IL -6, IL -8 and TNF were significantly higher in DM patients with microalbuminuria than those in patients without albuminuria （ P 〈 0.01 ）. Serum levels of CRP, IL- 6, IL- 8 and TNF were significantly higher in diabetic patients with macroalbuminuria thara those in patients with microalbuminuria （P 〈 0.01 ）. Conclusion Determination of serum TNF - α, IL - 6 and IL - 8 levels might be helpful for early detection of diabetic nephropathy and monitoring the progress of the disease process.