血清超敏C-反应蛋白和白细胞介素-6及肿瘤坏死因子-α水平在2型糖尿病肾病患者中的变化及临床意义

The clinical significance of the serum levels of hs - CRP and IL - 6 and TNF-α in patients with diabetic nephropathy

目的探讨2型糖尿病肾病（DN）患者血清超敏c-反应蛋白（hs—CRP）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平的变化及其临床意义。方法选择2型糖尿病患者100例，根据尿白蛋白排泄率（UAER）分为无白蛋白尿纽（DM纽）28例，早期糖尿病肾病组（DN，组）39例，临床糖尿病肾病组（DN，组）33例，另选健康体检者30例做为对照组。应用免疫比浊法测定血清hs—CRP水平，用ELISA法检测血清IL-6和TNF-α水平并与正常对照组比较。结果2型DN患者纽血清中hs—CRP、IL-6及TNF-α水平高于正常人组及DM组，且随DN的加重而增高，组间比较差异有统计学意义（P〈0．05）。结论hs—CRP、IL-6及TNF-α是2型DN的病理生理过程中重要的炎症介质，在2型DN的发生及发展过程中可能起重要作用，检测hs—CRP、IL-6及TNF-α有助于DN患者病情及预后的判断。

Objective To investigate the changes of serum hs - CRP,IL - 6,and TNF-α levels in patients with diabetic nephropathy （DN） and the clinical significance. Methods One hundred patients with type 2 diabetes were selected for this study. The patients were divided into three groups according to urinary albumin excretion rate （UAER） ： 28 patients with normal UAER as DM group, 39 patients with microalbuminuria as DN1 group and 33 patients as DN2 group. Thirty healthy subjects were used as control group. The serum levels of hs - CRP level was detected by immunoturbidimetry, IL - 6 and TNF-α concentrations were detected by enzyme - linked immunosorbent assay （ELISA）. Results Serum levels of hs - CRP,IL - 6 and TNF-α were significantly higher in patients with diabetic nephropathy than those in controls（ P 〈 0.05 ）. The serum levels of hs - CRP,IL -6 and TNF-α were increased steply with urinary albumin excretion rate （UAER） increase, the differences between the groups was sig- nificant （P 〈 0.05 ）. Conclusions Hs -CRP,IL- 6 and TNF-α participated in the pathogenesis of diabetic nephropathy. Monitoring the changes of their serum levels was helpful for the management of the disease, and probably be a prognostic factor of DN.