2型糖尿病患者微量尿清蛋白与血清相关炎症因子水平联检的临床意义

Clinical Significance of Combined Determination of Serum Relevant Inflammatory Factors （hs-CRP, IL-6,TNF-α） and Micro-Urinary Albumin Contents in Patients with DM2

目的 分析探讨2型糖尿病人血清超敏C反应蛋白（hs-CRP）、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）与24小时微量尿清蛋白（MUA）水平改变及其相关关系.方法 选取新诊2型糖尿病人49例为研究组及同期来院健康体检者50例为对照组,放射免疫法检测两组空腹血中hs-CRP、IL-6、TNF-α含量和24小时MUA水平,求算相关系数并进行回归分析.结果 ①2型糖尿病人空腹血糖（FPG）、体质指数（BMI）、血清相关炎症因子（hs-CRP、IL-6、TNF-α）水平及MUA含量与正常对照组相比明显升高,统计学有显著性差异（t=8.72～12.40,P＜0.01）.②控制性别、年龄,Person相关分析表明MUA与hs-CRP、IL-6、TNF-α及BMI呈显著相关,相关系数有统计学意义（r=0.25～0.40,P＜0.01～0.05）;以MUA为因变量逐步回归分析显示hs-CRP与BMI进入回归方程,提示三者间有一定的因果关系.结论 2型糖尿病人空腹血清hs-CRP、IL-6、TNF-α含量及24h微量尿清蛋白水平增高;hs-CRP可能参与糖尿病人肾微血管损伤致微量尿清蛋白水平升高.微量尿清蛋白及相关血清炎症因子水平检测可作为早期糖尿病肾损伤的灵敏指标.

Objective To study the level changes and inter- relationship between the serum contents of hs - CRP,IL - 6,TNF- α and 24 - hour micro - urinary albumin （MUA） in patients with type 2 diabetes mellitus. Methods Serum hs- CRP,IL- 6,TNF- α,24 - hour MUA （with RIA） and FPG （with biochemistry） contents were examined in 49 patients with newlydiagnosed DM2. Results The levels of serum FPG,hs- CRP,IL-6,TNF- αand 24 - hour MUA were significantly higher than those in normal control. Serum hs- CRP,IL - 6,TNF - αand 24 - hour MUA contents were mutually positively correlated （P〈 0.01 - 0.05）. Conclusion Serum hs - CRP,IL - 6,TNF - αand 24 - hour MUA contents were all significantly increased in patients with newly diagnosed DM2, perhaps hs - CRP involved the injury of renal vesicular. The levels of 24 - hour MUA and serum relevant inflammatory factors such as hs - CRP are the sensitive index to early injury of diabetic nephropathy.