Ⅱ型糖尿病患者血清Ⅳ型胶原水平的变化及意义

Clinical significance of serum type Ⅳ collagen in the patients with diabetic nephropathy

目的 探讨Ⅱ型糖尿病患者血清Ⅳ型胶原（ ＣⅣ） 的变化及其与糖尿病肾损害可能的关系和作用。方法 采用放射免疫法对８４ 例Ⅱ型糖尿病患者及４５ 例正常人血清 ＣⅣ水平进行检测。结果 糖尿病（ Ｄ Ｍ） 患者血清 ＣⅣ水平［（１０５ ．４８ ±１８ ．０９）μｇ／ Ｌ］ 明显高于对照组［（８９ ．２０ ±９ ．７０）μｇ／ Ｌ， Ｐ ＜ ００１］ ；微量及大量白蛋白尿期患者［（１０６ ．４６ ±１８ ．５９）μｇ／ Ｌ，（１２０ ．９０ ±１５ ．５４）μｇ／ Ｌ］ 较对照组显著增高（ Ｐ ＜ ００１ ， Ｐ＜ ０００１） ； Ｄ Ｍ 各组间血清 ＣⅣ水平差异显著，随着２４ 小时尿白蛋白 排泄量（ Ｕ Ａ Ｅ） 的增加及病程的延长，血清 ＣⅣ水平递增，病程超过５ 年者 显著高于病程短于５ 年者；血清 ＣⅣ与血尿素氮（ Ｂ Ｕ Ｎ） 、肌酐（ Ｃｒ） 、２４ 小 时 Ｕ Ａ Ｅ 及尿 Ｎ乙酰β氨基葡萄糖苷酶（ Ｎ Ａ Ｇ） 均呈显著正相关，与病程、空腹血糖（ Ｆ Ｂ Ｇ） 亦呈高度正相关。结论 Ｄ Ｍ 存在着胶原代谢的异常。血清 ＣⅣ水平随 Ｄ Ｎ 的严重程度而明显增高。血清 ＣⅣ可作为 Ｄ Ｎ

Objective To study the possible relationship between serum type Ⅳcollagen(CⅣ) and diabetic nephropathy(DN).Methods Serum CⅣ was determined by radioimmunoassay in 33 diabetic patients with normalbuminuria(A group), 32 cases of microalbuminuria(B group), 19 cases of macroalbuminuria(C group) and 45 normal subjects as control.Results The mean concentration of CⅣ in total 84 diabetic patients(105 48±18 09 μg/L) was higher than that of control(89 20±9 70 μg/L)(P<0 01), especially in group B(106 46±18 59 μg/L) and C(120 90±15 54 μg/L) was remarkablely higher as comparable with control(P<0 01,P<0 001). There was significantly positive correlation between serum CⅣ level and diabetic duration,UAE,BUN,Cr, FBG.Conclusion Abnormal collagen metabolism exists in diabetic patients. The increased serum CⅣ level in diabetic patients is related to the severity of diabetic renal lesion and could be an early and sensitive marker of DN.