糖尿病肾病不同病变时期内皮素、一氧化氮致病作用的研究

ROLE OF ENDOTHELIN AND NITRIC OXIDE IN DIABETICNEPHROPATHY

目的 :观察内皮素 (ET)、一氧化氮 (NO)在糖尿病肾病各期中的致病作用。方法 :应用放射免疫计数法、硝酸盐还原酶法、微柱层析法测定 6 4例糖尿病患者及 30例正常对照者的内皮素 (ET)、一氧化氮 (NO)、糖化血红蛋白(GHb A1 C)、胰岛素 (INS)、C肽 (CP)、空腹血糖 (FBG)、 2 4h尿白蛋白 (U AER)、α1 微球蛋白 (α1 - MG)等指标。糖尿病患者分为无糖尿病肾病组 (DM 组 )、早期糖尿病肾病组 (DM 组 )、临床糖尿病肾病组 (DM 组 )。应用均数±标准差、t检验、直线相关分析等统计学方法分析实验数据。结果 :糖尿病患者 ET明显高于对照组 ,DM 增高特别明显 (P<0 .0 1)。DM组及 DM 组 NO水平增高 ,与对照组比较无统计学意义 (P >0 .0 5 ) ,但 DM 组与对照组比较显著增高 (P>0 .0 1) ,DM 组较对照组显著降低 ,(P <0 .0 1)。结论 :在糖尿病肾病各期中 ET、NO均参与致病作用 ,在早期糖尿病肾病高滤过期与 NO显著升高密切相关 ,在临床糖尿病肾病期与 NO显著减少、 ET明显增高密切相关。

Objective:Studying the role of nitric oxide and Endothelin in the pathogenesis on diabetic nephropathy Methods:The circulating level of Endothelin and nitric oxide were measured in 30 normal subjects (C group) and 64 diabetic patients (DM group) by radioimmunoassay and colormetrin assay The DM group was divided into three groups:24 cases of normoalbuminuria groug (DMⅠgroup),UAER<20 μg/min,23 cases of incipient diabetic nephropabthy group (DMⅡ group),20 μg≤UAER≤200 μg/min;17 cases of overt diabetic nephropathy gronp (DMⅢroup),UAER>200 μg/min Results:ET concentration was markedly elevated in DM group than in C group (P<0 01) The development of diabetic nephropathy was accompanied with the high ET level There was positive correlated serum ET with INS in DM Ⅲ group NO level was significantly higher in DMⅡ group than in normad subjects(P<0 01) in DM group and DMⅠ group NO was insignificantly higher than C group (P>0 05) But in DMⅢ group,NO level was significantly reduced,much lower than in normal subjects Plasma ET with NO was negatively correlated in DM group Conclusion:The marked high NO level was correlated to the state of early diabetic nephropathy The marked decrease of NO and marked high level of ET were correlated to the clinic dialetic nepheropathy