2型糖尿病患者尿血管内皮生长因子的检测及临床意义

Detection of urinary vascular endothelial growth factor and its clinical significance in type 2 diabetes mellitus

目的:探讨不同尿白蛋白排泄率(UAER)的2型糖尿病患者尿VEGF排泄的变化及临床意义。方法:选择正常对照组22例和2型糖尿病组65例,根据UAER将糖尿病患者分为正常白蛋白尿组(23例)、微量白蛋白尿组(22例)和临床蛋白尿组(20例)。采用双抗体夹心酶联免疫吸附法(ELISA)测定尿VEGF,计算排泄率。结果:①与正常对照组相比,正常白蛋白尿组尿VEGF排泄率即可见显著升高(P<0.05)。2型糖尿病组内,微量白蛋白尿组和临床蛋白尿组尿VEGF较正常,白蛋白尿组显著升高(P<0.05或P<0.01),临床蛋白尿组较微量白蛋白尿组尿VEGF显著升高(P<0.05),各组间比较,差异有统计学意义(P<0.05)。②尿VEGF排泄率与UAER、血浆肌酐、病程呈正相关。③多元回归分析显示影响尿VEGF排泄率的因素为UAER、血浆肌酐。结论:2型糖尿病患者尿VEGF排泄率升高先于UAER的变化,并与肾脏病变的程度有关,提示尿VEGF可作为糖尿病肾病的早期敏感指标,并可预示糖尿病肾病的进展。

Objective To study the changes of urinary vascular endothelial growth factor（UVEGF） excretion and its clinical significance in type 2 diabetes mellitus（T2DM） patients with different urinary albumin excretion rate.Method For 22 normal controls and 65 of type 2 diabetics were recruited into this study.The 65 type 2 diabetics were divided into 3 groups according to urinary albumin excretion rate（UAER）：normal albuminuria group（n =23）,microalbuminuria group（n =22）,clinical albuminuria group（n =20）.Urinary VEGF levels were measured by using ELISA method.Results ①UVEGF excretion rate in normal albuminuria group was obviously higher than that in controls（P 0.05）.In T2DM group,UVEGF excretion rate in microalbuminuria and clinical albuminuria groups were significantly higher than that in normal albuminuria group（P 0.05 or P 0.01）.UVEGF excretion rate in clinical albuminuria group was obviously higher than that in microalbuminuria group（P 0.05）.There was significant differences among each group.②UVEGF excretion rate was positively related to UAER,plasma creatinine and course of diseases.③Multiple regression analysis displayed that UAER and plasma creatinine were affecting factors of UVEGF excretion rate.Conclusion Increases of UVEGF in type 2 diabetes are ahead of changes of UAER and are related with the degree of pathological changes of kidney.UVEGF might be a sensitive factor of the early stage of diabetic nephropathy.It might predict the evolvement of diabetic nephropathy.