糖尿病肾病患者血清Ⅳ型胶原和层粘连蛋白水平的变化及临床价值

Change and clinical value of the serum level of type Ⅳ collagen and laminin in patients with diabetic nephropathy

目的探讨糖尿病肾病（DN）患者血清中Ⅳ型胶原（C—Ⅳ）和层粘连蛋白（LN）水平的变化及其临床价值。方法用放射免疫法测定81例糖尿病（DM）患者（男48例，女33例）的血清C—Ⅳ和LN含量，分为正常白蛋白尿组36例，微量白蛋白尿组29例和大量白蛋白尿组16例，并以5O例健康体检者为对照。用直线相关分析糖尿病患者血清C—Ⅳ、LN与其它临床指标之间的相关性。结果81例DM患者血清C—Ⅳ[（74．6±24．2ug／L]、LN[（137．1±29．5）ug／L]水平明显高于对照组[（45．4±7．9）、（98．6±15．4）ug／L，P〈0．01]；DM各亚组患者血清C—Ⅳ、LN水平均明显高于对照组（P〈0．05，P〈0．01）；DM各组间血清C-Ⅳ、LN水平随尿白蛋白量的增加而升高，差异有统计学意义（P〈0．05，P〈0．01）。直线相关分析提示血清LN及C-Ⅳ水平均与BUN、Cr、HbhlC、UAER相关（P〈0．05，P〈0．01），血清C-Ⅳ、LN水平与FBG无相关性（P〉0.05）。结论血清C-Ⅳ、LN水平与糖尿病肾病病程的发生发展密切相关，联合检测血清C-Ⅳ、LN、HbAlc、UhER可能更早、更全面地反映DN的病变程度。

Objective To study the change and clinical value of serum levels of collage （C-Ⅳ） and laminin（LN） in diabetic nephropathy （DN） patients. Methods The level of C-Ⅳ and LN in 81 diabetes （DM） with diabetes and 50 normal controls were detected by radio-immunoassay （RIA）, 81 DM patients were divided into three groups： 36 cases normal albumin urea（group A）, 29 cases of micro albumin urea（group B）, 16 cases of macro albumin urea（group C）.And the correlation between serum C-Ⅳ, LN levels in diabetic patients and other clinical reference factors were analyzed by liner correlation. Results The serum levels of C-Ⅳ and LN in DM patients were obviously higher than those of normal controls（P〈0. 01）, the serum levels of C-Ⅳ and LN in all group of DM patients were higher than those of normal control（P〈 0.05, P〈 0. 01）.Moreover, there were significant difference of the levels of C-Ⅳ and LN among all group of DM （P〈0.05, P〈0.01）. There was positive correlation of serum C-Ⅳ, LN to the levels of blood urea nitrogen（BUN）, creatinine（Cr）, HbAlC, urinary albumin excretion rate（UAER）. The serum levels of C-Ⅳ and LN were no correlated with FBG （P〉0.05）.Conclusions There were closely related between the serum level of C-Ⅳ, LN and the DN. There may be indicate early and generally the development process of DN by combination determination of serum level of C-Ⅳ, LN , HbAlc and Urinary albumin excretion rate.