TGF-β1、TNF-α和尿微量白蛋白与糖尿病肾病的关系

Clinical Significance of Determination of Transforming Growth Factor Beta1,Tumor Necrosis Factor Alpha and Urine Microalbumin Levels in Patients with DM2 Nephropathy

【目的】探讨2型糖尿病肾病(DN)患者转化生长因子β1(TGF-β1)、肿瘤坏死因子α(TNF-α)和尿微量白蛋白水平的变化及意义。【方法】对100例2型糖尿病(DM)患者[其中正常白蛋白尿组30例,微量白蛋白尿组(MA组)DN38例,临床白蛋白尿组(CP组)DN32例]和26例正常对照组,用免疫比浊法检测尿微量白蛋白,ELISA法检测TGF-β1水平,化学发光法检测TNF-α。【结果】DN组TGF-β1、TNF-α和尿微量白蛋白水平均明显高于正常对照组(P<0.01)。正常白蛋白尿组与对照组比较差异无显著性(P>0.05)。MA和CP组的尿微量白蛋白与TGF-β1、TNF-α有正相关关系。【结论】TGF-β1、TNF-α和尿微量白蛋白含量随DN的发生以及严重程度逐渐增高,可作为早期诊断DN较敏感的指标,对于监测早期DN的发生和病情发展程度有重要意义。

[Objective]To investigate the clinical significance of determination of transforming growth factor beta1 （TGF-β1）, tumor necrosis factor （TNF-α） and ：urine microalhumin levels in patients with type 2 diabetes mellitus （DM2） nephropathy. [Methods]TGF-β1, TNF-α and urine microalhumin levels were determined in 26 controls and 100 patients with DM2 （30 cases with normal urine albumin, 38 cases with urine microalhumin and 32 cases with clinical urine albumin） by ELISA, chemoluminescence and immunoturhidimetry. [Results] The levels of TGF -β1, TNF-α and urine microalhumin contents in diabetic patients with nephropathy were significantly higher than those in controls （ P 〈0.01）, and those in diabetic patients without nephropathy were higher than those in controls, hut there was no significant difference （ P 〉0.05）. The level of urine microahlumin was positively correlated with those of TGF-β1 and TNF-α in microalhumin group and clinical urine albumin group. [Conclusion]TGF-β1, TNF-α and urine microalhumin levels increase gradually as the diabetic nephropathy becomes more severe. They can he used as sensitive markers for the early surveillance of the development of diabetic nephropathy.