足细胞标志蛋白检测在糖尿病肾病中的临床应用价值

The expression of podocalyxin in patients with diabetic nephropathy and its clinical significance

目的检测糖尿病肾病（DN）患者足细胞标志蛋白（PCX）表达的变化，并探讨其相关的临床意义。方法选择DN患者68例（DN组），按尿白蛋白与肌酐比值分为三个亚组：正常蛋白尿组（〈30mg／g，A组）、微量白蛋白尿组（〉130mg／g而〈300mg／g，B组）、大量白蛋白尿组（≥300mg／g，C组）。另选择健康体检者20例作为对照组，酶联免疫吸附试验法检测尿沉渣中PCX表达水平。结果DN组患者尿沉渣中PCX、血肌酐、血尿素氮的表达水平显著高于对照组[（27．44±6．87）μg／L比（3．52±1．13）μg／L、（154．82±11．54）μmol／L比（82．56±5．71）μmol／L、（8．79±0．58）mmol／L比（4．23±0．34）mmol／L，P〈0．01]；A、B、C组PCX的表达水平分别为（18．04±4．12）、（23．58±5．43）、（32．18±6．05）μg／L，差异均有统计学意义（P〈0．05）；A、B、C组血肌酐、血尿素氮分别为（138．54±8．66）、（142．16±11．74）、（165．13±12．85）μmol／L，（8．48±0．43）、（8．56±0．61）、（10．04±1．17）mmol／L，血肌酐、血尿素氮在A组和B组比较差异无统计学意义（P〉0．05），但在A组和C组、B组和C组比较差异有统计学意义（P〈0．05）。结论DN患者尿沉渣中存在PCX的高表达，检测PCX有利于DN患者肾损害的早期诊断和病变程度的评估。

Objective To investigate the expression of podocalyxin（PCX） in patients with diabetic nephropathy （DN） and its clinical significance. Methods A total of 68 patients with DN were enrolled as DN group. Another 20 healthy person were selected as control group. The patients with DN were divided into three sub-groups： normal albuminuria group（ 〈 30 mg/g, group A ）, microalbuminuria group （ ≥ 30 mg/g but 〈 300 mg/g,group B） and macroalbuminuria group （ ≥300 mg/g,group C）. The level of urinary PCX was measured with enzyme-linked immunosorbent assay. Results The level of urinary PCX, serum creatinine and blood urea nitrogen in DN group was higher than that in control group [ （ 27.44 ± 6.87 ） μ g/L vs. （3.52 ± 1.13 ） μ g/L, （ 154.82 ± 11.54 ） μ mol/L vs. （82.56 ± 5.71 ）μ mol/L, （ 8.79± 0.58 ） mmol/L vs. （4.23 ± 0.34） mmol/L,P 〈0.01]. The level of urinary PCX in group A, B, C was （18.04 ±4.12）, （23.58 ±5.43）, （ 32.18 ± 6.05 ）μ g/L, and there was significant difference among three groups（P 〈 0.05 ）. The level of serum creatinine and blood urea nitrogen was （ 138.54 ± 8.66）, （ 142.16 ± 11.74）, （ 165.13 ± 12.85 ） μmol/L and （8.48 ± 0.43）, （8.56 ± 0.61 ）, （ 10.04 ± 1.17） mmol/L in group A, B, C, there was no significant difference between group A and group B（P 〉 0.05 ）, but there was significant difference between group A and group C, or between group B and group C（P〈 0.05 ）. Conclusion The high-level expression of urinary PCX is foundin DN patients, which maybe play a key role in the early diagnosis and assessment of the progression of DN.