糖尿病肾病患者红细胞形态功能变化与病程发展的关联性研究

Study on the relevance of changes in red blood cell morphology and function of patients with diabetic nephropathy to the development of diabetes

目的:定量测定糖尿病肾病(DN)患者不同发展阶段红细胞形态和红细胞膜弹性的变化。方法:健康组(A组)26例,作为对照组;2型糖尿病(T2DM)患者79例,其中,肾功能正常组(B组)24例,肾功能轻度下降组(C组)23例,肾功能重度下降组(D组)26例。利用新型显微成像与分析技术,测量所有受检者红细胞形态、功能和红细胞胞膜弹性的相关参数。结果:红细胞的形态参数:红细胞截面积和半径、功能参数:刚性系数、及细胞膜弹性参数:弯曲模量和剪切模量从A到D组逐渐增大,B组红细胞形态参数与A组比较,差异无统计学意义(P>0.05),B组红细胞功能和膜弹性参数、C和D组红细胞参数与A组比较,差异均有统计学意义(P<0.01)。B、C、D组间红细胞变形能力和膜弹性参数两两比较,差异均有统计学意义(P<0.01)。结论:提示糖尿病肾病患者红细胞的形态和功能参数的变化与糖尿病肾病发生发展的进程密切相关。红细胞变形能力和膜弹性参数可作为辅助判断糖尿病肾病患者肾功能下降的指标。

Aim：Quantitative determine the changes in the red blood cell （RBC）morphology,func-tion and membrane elasticity of diabetic nephropathy （DN）patients with different stages of development. Methods：The RBC morphology,function and membrane elasticity were quantitative analyzed with a new microscopic imaging and analysis techniques in 26 healthy individuals,as for a control group （A group）, and 79 patients with type 2 diabetes mellitus（T2DM）,of which there are 24 patients with normal renal function （B group）,23 patients with slightly decreased renal function （C group）and 26 patients with severe decreased renal function （D group）.Results：Morphological RBC parameters,cross-sectional ar-ea and radius,function parameters,stiffness coefficient,membrane elasticity parameters,flexural modu-lus and shear modulus from group A to D gradually increase.There were no significant differences be-tween group B and A in RBC morphology parameters （P〉0.05 ）.There were significant differences be-tween B and A in RBC function and membrane elasticity parameters （P〈0.01 ）.There were significant differences between group C,D,and goup A in all the RBC parameters （P〈0.01 ）.There were signifi-cant differences among group B,C,D in deformation capacity and elastic parameters of the cell mem-brane （P〈0.01 ）.Conclusion：It was suggested that the changes in RBC morphology and function pa-rameters is closely related with the development of DN,and the RBC deformability and membrane elastic-ity parameters can be use as a indicator for the renal function decline.