2型糖尿病肾病患者尿白蛋白与血浆内皮素、心钠素、降钙素基因相关肽的关系

Relationship Between the Plasma Levels of Endothelin (ET), Atrial Natriuretic Peptide and Calcitonnin Gene-Related Peptide and Type 2 Diabetic Nephropathy

[目的 ]探讨血浆内皮素、心钠素在糖尿病肾病病人尿白蛋白形成和发展中的作用。 [方法 ]采用放射免疫分析法测定了 66例 2型糖尿病及糖尿病肾病患者和 46名健康人的血浆内皮素、心钠素及降钙素基因相关肽水平。 [结果 ]糖尿病及糖尿病肾病患者血浆内皮素、心钠素水平显著高于正常人 (P <0 0 1 ) ,且与尿白蛋白排泄率呈正相关(r内皮素=0 58、r心钠素=0 60 ,P <0 0 1 ) ;血浆降钙素基因相关肽虽在糖尿病病人中略有升高 ,但与对照组的差异无统计学意义 ,与尿白蛋白排泄率无显著相关。 [结论 ]Ⅱ型糖尿病肾病患者血浆内皮素、心钠素升高与糖尿病长期代谢紊乱、尿白蛋白排泄有关 ,提示内皮素。

Objective\]To investigate the relationship between the plasma concentration of endothelin (ET), atrial natriuretic peptide (ANP) and calcitonin gene related peptide (CGRP) in patients with different stages of diabetic nephropathy.\Plasma concentrations of endothelin (ET), atrial natriuretic peptide (ANP) and calcitonin gene related peptide (CGRP) were measured with radioimmunoassay in 46 normal subjects and 66 patients with diabetes or diabetic nephropathy. \The levels of ET and ANP were significantly higher in diabetic nephropathy than in subjects (P<0 01), and elevation accompanied by urinary albumin excretion(UAER) increase .There was significant positive correlation between the level of ET,ANP and UAER(r=0 58?0 60,P<0 01).Though the concentration of CGRP was slightly higher in diabetes, there was no significant difference between the level of CGRP in diabetes and in subjects, and no significant correlation between CGRP and UAER.\[Conclusions\]It is shown that progressive elevation level of ET and ANP in Type 2 diabetic nephropathy is closely related with long term metabolic disorder of diabetes mellitus and excretion of albuminuria , suggesting the important role of the ET and ANP in the development of albuminuria of Type 2 diabetic nephropathy.