糖尿病肾病患者血管活性物质检测的临床意义

Clinical significance of detection of vasoactive substances in patients with diabetic nephropathy

目的:探讨糖尿病肾病(DN)患者血管活性物质检测的临床意义。方法:选择2型糖尿病患者138例作为研究对象,根据24h尿微量白蛋白(MAU),分为单纯糖尿病组(DM组)、早期糖尿病肾病组(EDN组)和临床糖尿病肾病组(CDN组),同时选择年龄和性别相匹配的35例健康者作为对照组,测定各组患者血管活性物质(ET、Ang-Ⅱ、TXB2、NO)和MAU水平并进行比较。结果:DM组、EDN组和CDN组的炎症因子与MAU均高于健康对照组(P<0.05);从DM组、EDN组至CDN组,MAU越来越高,ET、Ang-Ⅱ、TXB2逐渐增高,NO逐渐下降,各组患者相比具有统计学意义(P<0.05);MAU与ET、Ang-Ⅱ、TXB2呈正相关(P<0.05),与NO呈负相关(P<0.05)。结论:循环血液中的血管活性物质水平与DN的肾损害程度相关,可以作为DN的诊断和预后的可能指标。

Objective：To investigate clinical significance of detection of vasoactive substances in patients with diabetic ne-phropathy （ DN） . Methods：138 patients with type 2 diabetes mellitus were selected as research subjects and divided into diabetes mel-litus group （ DM group） , early diabetic nephropathy group （ EDN group） and clinic diabetic nephropathy group （ CDN group） accord-ing to 24h microalbuminuria （MAU）, and 35 health people with matched ages and sex were used as control group. The vasoactive sub-stances （ET, Ang-Ⅱ, TXB2, and NO） and 24h MAU were measured and compared among each group. Results： The inflammatory factors and MAU in DM group, EDN group and EDN group were significantly higher than those in control group （P〈0. 05）. From the DM group, EDN group to CDN group, ET, Ang-Ⅱ, TXB2 and MAU increased gradually, while NO decreased gradually, and there were statistical significance among each group （P〈0. 05）. It showed there were positive correlations among ET, Ang-Ⅱ, TXB2 and MAU （P〈0. 05） and there was a negative correlation between NO and MAU （P〈0. 05）. Conclusions： The vasoactive substances in the circulating blood are related with the degree of renal injury, and can be the possible indicators for the diagnosis and prognosis of DN.