检测糖尿病肾病患者血清细胞因子的意义

The clinical significance of detection of serum levels of slCAM-1, IL-6, IL-8 and TNF-α in patients with diabetic nephritis

目的探讨2型糖尿病肾病患者血清可溶性细胞间粘附分子（sICAM-1）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和肿瘤坏死因子-α（TNF-α）水平的变化及意义。方法选择2型糖尿病患者90例，根据尿白蛋白排泄率（UAER）分组：其中无白蛋白尿患者（DM组）24例，早期糖尿病肾病患者31例（DN1组），临床糖尿病肾病患者35例（DN2组），另外选择30例健康体检者作为对照（对照组）。采用酶联免疫吸附法（ELISA）测定各组血清sICAM-1、IL-6、IL-8和TNF-α水平并进行统计学分析。结果2型糖尿病肾病患者血清中sICAM-1、IL-6、IL-8和TNF-α水平高于正常对照组及DM组（t=5．68，5．12，4．87，4．96P〈0．05），DN2组血清中sICAM-1、IL-6、IL-8和TNF-α水平高于DN1组，组间比较差异有统计学意义（t=4．62，4．23，4．35，4．38，P〈0．05）。结论炎症因子sI-CAM-1、IL-6、IL-8和TNF-α可能参与了DN的病理生理过程，检测sICAM-1、IL-6、IL-8和TNF-α有助于DN患者病情及预后的判断。

Objective To investigate the changes of serum sICAM-1, IL-6, IL-8 and TNF-α levels in patients with diabetic nephritis and the clinical significance. Methods Ninety patients with type 2 diabetes were enrolled in this study. The patients were divided into three groups according to uri- nary albumin excretion rate（UAER） ： 24 patients with normal UAER were in DM group, 31 patients with microalbuminuria were in DN1 group and 35 patients with clinical urine protein were in DN2 group. Thirty healthy subjects were choosed as control group. The serum levels of sICAM-1, IL-6, IL-8 and TNF-α were measured by ELISA and the results were analyzed statistically. Results The serum levels of sI- CAM-1, IL-6, IL-8 and TNF-α were significantly higher in patients with diabetic nephropathy than those in control group and DM group（ t = 5.68,5.12,4. 87,4.96, P 〈 0. 05）. The serum levels of sICAM-1, IL-6, IL-8 and TNF-α were significantly higher in DN2 group than those in DN1 group （ t =4. 62,4. 23, 4.35,4. 38, P 〈 0. 05 ）. Conclusions sICAM-1, IL-6, IL-8 and TNF-α may participate in the patho- genesis of diabetic nephropathy. Monitoring the changes of their serum levels was helpful for the manage- ment and prognosis judgement of the disease.