2型糖尿病伴微量白蛋白尿患者血清B型脑钠肽与肾功能的相关性研究

Study on the Relationship Between Serum Brain Natriuretic Peptide and Renal Function in Type 2 Diabetic Nephropathy Patients with Microalbuminuria

【目的14g讨2型糖尿病伴微量白蛋白尿（MT2DM）患者血清B型脑钠肽（BNP）水平与肾功能的关系。【方法】选择MT2DM患者88例（MT2DM组）和2型糖尿病伴正常白蛋白尿（NT2DM）患者64例（NT2DM组），测量两组身高、体重、血压，测定空腹血糖（FPG）、血脂、糖化血红蛋白（HbAlc）、BNP、超敏c反应蛋白（hs—CRP）、尿白蛋白排泄率和估计肾小球滤过率（eGFR）。【结果】与NT2DM组比较，MT2DM纽血清BNP水平明显升高（P〈0．05），而eGFR明显降低（P〈0．05）；Spearman相关分析显示，MT2DM组收缩压（SBP）、低密度脂蛋白胆固醇（LDL-e）、hs—CRP、BNP、HbAlC与eGFR呈负相关；多元线性回归分析进一步提示，BNP、LDL-C和HbAlc是MT2DM患者eGFR的独立影响因素。【结论】MT2DM患者血清BNP与eGFR关系密切，提示BNP可能参与了糖尿病早期肾病的发生。

[Objective]To explore the relationship between serum brain natriuretic peptide（BNP） and renal function in patients with type 2 diabetic nephropathy and microalbuminuria（MT2DM）. [Methods] A total of 64 MT2DM patients（group MT2DM） and 64 patients with Type 2 diabetes mellitus and normal buminuria （NT2DM） （group NT2DM） were chosen. Height, weight and blood pressure of two groups were measured. Fasting blood glucose（FPG）, blood lipids, glycated hemoglobin（HbAlc）, BNP, high sensitivity C-reactive protein（hs-CRP）, urinary albumin excretion rate and estimated glomerular filtration rate （eGFR） were exam- ined. [Results] Compared with NT2DM group, BNP level in MT2DM group obviously increased （ P 〈0.05） and eGFR obviously decreased（ P 〈0.05）. Spearman correlation analysis showed that systolic blood pressure （SBP）, low-density lipoprotein cholesterol（LDL-c）, hs-CRP, BNP and HbAlc in MT2DM group were nega- tively correlated with eGFR. Multiple linear regression analysis revealed that BNP, LDL-c and HbAlc were independently influential factors of eGFR in MT2DM patients. [Conclusion] Serum BNP is closely associated with eGFR in MT2DM patients, which indicates that BNP may involve in the development of early diabetic ne phropathy.