2型糖尿病人尿白蛋白排泄率与尿IgG_4的相关研究

Associated Study on UAER and Urinary IgG_4 in Type 2 Diabetic Patients

目的 测定 18例正常人和 70例 2型糖尿病病人 2 4小时尿UAER(mg/ 2 4h)和尿IgG4 ( μg/ 2 4h) ,计算IgG4 /AER指数 .方法 70例 2型糖尿病病人分为 3组 :正常尿蛋白组 2 5例 (NDN组 ,UAER <30mg/ 2 4h)、微量白蛋白组 2 7例 (EDN组 ,UAER30～ 30 0mg/ 2 4h)和临床期肾病组 18例 (CDN组 ,UAER >30 0mg/ 2 4h) .结果 尿IgG4 水平CDN组( 338.4± 2 2 8.5ug/ 2 4h)、EDN组 ( 96 .0± 81.7ug/ 2 4h)均明显高于NDN组 ( 9.9± 6 .3ug/ 2 4h)和正常对照组 ( 9.8± 4.4ug/2 4h) ,差异有非常显著性 (p<0 .0 1) .IgG4 /AER指数在CDN组明显降低 ( 0 .31± 0 .2 8) ,与EDN组 ( 0 .87± 0 .6 3)、NDN组( 0 .6 8± 0 .40 )和正常对照组 ( 0 .6 6± 0 .33)分别比较 ,差异有显著性 (p <0 .0 5 ) .3组糖尿病人分别进行UAER与IgG4 直线相关分析 ,结果NDN组 (r=0 .6 15 3) ,EDN组 (r=0 .75 5 0 ) ,呈非常显著正相关 (p <0 .0 0 1) ,CDN组 (r=0 .16 15 )两者之间无显著相关 (p >0 .0 5 ) .结论 尿IgG4 水平在早期糖尿病肾病已显著升高 ,与UAER显著正相关 ,IgG4

Objective The UAER (urinary albumin ejection rate,mg/24h) and levels of urinary IgG 4(μg/24h)were detected,IgG 4/AER index was counted in 70 Type 2 diabetics and 18 healthy individuals.Methods 70 patients were devided into three groups.The UAER was lower than 30mg/24h in group NDN (25 patients),30-300mg /24h in group EDN (27 patients) and higher than 300mg/24h in group CDN(18 patients).Results The levels of urinary IgG 4 was higher significantly in group CDN ( 338.4+228.5 ug/24h) and in group EDN(96.0+81.7ug/24h)compared to group NDN (9.9+6.3ug/24h) and healthy subjects (9.8+ 4.4 ug/24h),p<0.01.IgG 4/AER index was lower significantly in group CDN(0.31+0.28) compared separately to group EDN(0.87+0.63),group NDN(0.68+0.40) and healthy subjects (0.66+0.33),p<0.05.The association between the UAER and urinary IgG 4 values was studied separately in three group patients by linear relation analysis.The both were correlated significantly in group NDN(r=0.6153,p<0.001) and group EDN(r=0.7550,p<0.001),and not correlated in group CDN( r=0.1615 , p>0.05 ).Conclutions levels of urinary IgG 4 was increased significantly in early stage of diabetic nephropathy and correlated with UAER,and IgG 4/AER index decreased that might be the development of diabetic nephropathy.