2型糖尿病肾病患者血清血红素加氧酶－1检测的临床意义

Clinical significance of serum levels of heine oxygenase-1 in type 2 diabetic nephropathy

目的 探讨2型糖尿病肾病患者血清血红素加氧酶-1（HO-1）的变化及意义.方法 将225例2型糖尿病患者根据尿微量白蛋白排泄率（UAER）分为3组：单纯糖尿病组96例（UAER＜ 30 mg/24 h）,早期肾病组71例（30 mg/24 h≤UAER ＜300 mg/24 h）,临床肾病组58例（UAER＞300 mg/24 h）.另选取60例健康体检者作为对照组.采用酶联免疫吸附试验（ELISA）测定患者血清HO-1及丙二醛浓度,并比较各组HO-1的水平.结果 2型糖尿病肾病患者血清HO-1及丙二醛水平较单纯糖尿病组及对照组明显升高（P均＜0.01）.糖尿病肾病患者中,临床肾病组HO-1水平明显高于早期肾病组（P＜0.01）.Pearson相关分析显示,HO-1与UAER呈正相关（r=0.485,P＜0.01）.结论 血清HO-1检测在2型糖尿病肾脏损伤早期即出现异常,并随着肾脏损害程度的加重而升高,其在2型糖尿病肾病的早期诊断及预测疾病进展中具有一定的临床意义.

Objective To investigate the changes and clinical significances of serum heine oxy- genase-1 （ HO-1 ） in diabetic nephropathy. Methods Patients with type 2 diabetes mellitus（T2DM） were divided into simple diabetes mellitus group （SDM, UAER 〈 30 mg/24 h, n = 96 ）, early diabetic nephropathy group（ EDN ,30 mg/24 h ≤ UAER 〈 300 mg/24 h, n = 71 ） and clinical diabetic nephropathy group （ CDN, UAER 〉 300 mg/24 h, n = 58 ）. A total of 60 healthy individuals were involved as control. The serum HO-1 and malondialdehyde（MDA） were measured by enzyme-linked immunosorbent assay（ELISA）. Results The serum levels of HO-1 and MDA in diabetic nephropathy group were significantly higher than that in simple diabetes mellitus group and control（ P 〈 0.01, respectively ）. In diabetic nephropathy group, the serum levels of HO-1 and MDA in CDN group were significantly higher than that in EDN group（P 〈 0.01 ）. Pearson linear correlation analysis showed that the serum levels of HO-1 was positively correlated with urinary albumin excretion rate （ r = 0. 405, P 〈 0.01 ）. Conclusion The serum concentrations of HO-1 changed early in type 2 diabetic kidney injury,and are consistent with the severity of diabetic ne- phropathy. Detection of serum levels of heme oxygenase-1 is useful in early diagnosis of diabetic nephropathy and in evaluating the degrees of renal injury of T2DM.