血清同型半胱氨酸、白细胞介素-6及可溶性细胞间粘附分子在2型糖尿病肾病患者中的变化及临床意义

Changes of the serum Hcy, IL-6 and sICAM-1 in patients with diabetic nephritis and its significance

目的探讨2型糖尿病肾病患者血清同型半胱氨酸（Hcy）、白细胞介素-6（IL-6）和可溶性细胞间黏附分子（sICAM-1）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）分为单纯糖尿病组（DM组）29例，早期糖尿病肾病组（DNI组）34例，临床糖尿病肾病组（DN2组）37例，另选健康体检者30例作为对照组。采用酶联免疫吸附法（ELISA）分别测定各组血清Hcy、IL-6及sICAM-1水平。结果2型糖尿病肾病患者血清中Hcy、IL-6及sICAM-1水平高于正常对照组及DM组，且随糖尿病肾病的加重血清中Hcy、IL-6及sICAM-1水平逐渐增高，组间比较差异有统计学意义（P〈0．05）。结论Hcy、IL-6及sICAM-1是2型糖尿病肾病病理生理过程中重要的炎性介质，在其发生及发展过程中可能起重要作用。检测Hcy、IL-6及sICAM-1有助于DN患者病情及预后的判断。

Objective To investigate the changes of serum homocysterine（Hcy）, interleukin-6 （IL-6） and soluble intercellular adhesion molecule-1 （sICAM-1） levels in patients with diabetic nephritis （DN） and its 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） ： 29 patients with normal UAER were in DM group, 34 patients with microalbuminuria were in DN1 group and 37 patients with clinical urine protein were in DN2 groups. Thirty healthy subjects were choosed as control group. The serum levels of Hcy, IL-6 and sICAM-1 were measured by enzyme linked immunosor- bent assay. Results Serum levels of Hcy, IL-6 and slCAM-1 were significantly higher in patients with diabetic nephropathy than those in control group and DM group （P 〈0. 05 ）, and the levels were increased with the severity of DN. Conclusions Serum Hcy, 1L-6 and sICAM-1 participated in the patho-genesis of diabetic nephropathy. Monitoring the changes of the serum levels are helpful for judgement of the severity and prognosis of DN.