2型糖尿病肾病患者MCP-1浓度的改变及意义

Changes of monocyte chemoattractant protein-1 in patients with diabetic nephropathy

目的观察临床2型糖尿病肾病患者的血清单核细胞趋化蛋白-1(MCP-1)浓度变化,探讨其临床意义。方法临床随机选择2型糖尿病(T2DM)患者61例,根据24h尿微量白蛋白定量(24h-UA)分为糖尿病对照组(T2DM对照组,35例)和糖尿病肾病组(DN组,26例),另外以正常健康人30例为正常对照组。所有入选观察对象均测定空腹血糖(FPG)、糖化血红蛋白(HbA1c)、高敏C反应蛋白定量(hs-CRP)、血清MCP-1浓度和24h-UA。结果与正常对照组比较,T2DM对照组和DN组的FPG、HbA1c、hs-CRP与MCP-1均显著升高(P<0.05)。与T2DM对照组比较,DN组的FPG、HbA1c无明显差异,但是血清hs-CRP、MCP-1浓度和24h-UA均明显升高(P<0.05)。DN组患者的MCP-1浓度与hs-CRP定量有明显的正相关性(r=0.305,P<0.05)。结论糖尿病肾病患者存在明显的炎症应激,导致MCP-1显著升高,MCP-1可以作为糖尿病肾病诊断和病情判断的重要实验室参考指标。

Objective To investigate the changes and significance of monocyte chemoattractant protein-1 （MCP-1）in patients with Diabetic nephropathy （DN）. Methods According quantitative level of 24-hour urinary albumin （24h-UA）, 61 patients with type 2 diabetic mellitus （T2DM）were divided into T2DM group（n=35）and DN group（n=26）. 30 healthy subjects were chosen to control group. Fasting blood glucose （FPG）,glyeosylated hemoglobinm （HbAlc）,high sensitivity C-reactive protein（hs-CRP）,MCP-1 and 24h-UA were measured in all three groups. Results 1. Compared to those in the control group,the serum concentrations of FPG,HbAlc,hs-CRP and MCP-1 and quantitative level of 24h-UA in the T2DM group and the DN group were significant increased （P〈0.05）. 2. FPG and HbAlc were no significant difference between the T2DM group and the DN group, hs-CRP, MCP-1 and 24h-UA in the DN group were higher than those in the T2DM group（P〈0.05）. 3. The serum concentration of MCP-1 has a significant positive correlation to quantitative level of 24h-UA in the DN group （r=-0.305,P〈0.05）. Conclusion There was significant inflammatory stress in patients with DN, and serum concentrations of MCP-1 increased. MCP-1 can be used as an important laboratory index for diagnosis and severity assessment of DN.