2型糖尿病合并终末期肾病外周血CD_(34)^+细胞水平的临床研究

Clinical study on the changes of CD_(34)^+ cells in patients with type 2 diabetes mellitus complicated by terminal stage nephropathy

目的分析CD+34细胞与糖尿病肾病代谢参数的相关性及其与糖尿病肾病发病的关系。方法选择终末期肾病患者100例,根据是否合并2型糖尿病分为合并糖尿病的终末期肾病组(n=55),为终末期肾病组(n=45)。糖尿病组(n=50)。同时选取体检中心健康体检者作为健康对照组(n=60)。比较4组三酰甘油(TG)、胆固醇(TC)、空腹血糖(FPG)、餐后2 h血糖(2 h FPG)、糖化血红蛋白(Hb A1c)、CD+34细胞/单核细胞值,尿微量白蛋白、肌酐(Cr)水平测定,肾小球滤过率的差异,以及各指标间的相关性。结果与阴性健康对照组比较,3个试验组CD+34细胞在单核细胞中的比值降低(P<0.05);糖尿病组高于终末期肾病组、糖尿病合并终末期肾病组(P<0.05)。糖尿病合并终末期肾病组外周血CD+34/单核细胞值与HBA1c、Cr、FPG、微量白蛋白、2 h FPG呈负相关(r值分别为-0.439、-0.241、-0.298、-0.342、-0.447,P<0.05)。结论 CD+34细胞可能是肾病患者的危险因素,参与肾病的发生,监测CD+34细胞水平变化也许能用来预测2型糖尿病患者合并终末期肾病的发生发展,其中糖尿病可能进一步导致CD+34细胞数量的下降。

Objective To analyze the correlation between CD34^＋ cells and the parameters of diabetic nephropathy as well as the pathogenesis of diabetic nephropathy.Methods One hundred patients with terminal stage nephropathy were divided terminal stage nephropathy A group （ with diabetes, n =55 ） and terminal stage nephropathy B group （ without diabetes, n =45）,simple diabetes group （ n =50）,at the same time,60 healthy subjects were enrolled as control group.The TG,TC,FPG,2 hFPG,HbA1c,ratio of CD34^＋ cells/monocytes,urine microcontent albumin,muscle anhydride levels,glomerular filtration rate were detected and comparted in the four groups.Results As compard with that in control group,the ratio of CD34^＋ cells/monocytes in three experimental groups were obviously decreased （ P〈0.05 ） , which in diabetes group was significantly higher than that in terminal stage nephropathy A group and terminal stage nephropathy B group （ P〈0.05） .The ratio of CD34^＋ cells/monocytes was negatively correlated to HbA1c, Cr, FPG in terminal stage nephropathy A group （ r =-0.439,-0.241,-0.241,-0.342,-0.298,respectively, P〈0.05）.Conclusion CD34^＋ cells may be risk factors for patients with diabetic nephropathy, which may be involved in the pathiogenesis of diabetic nephropathy, so monitoring the changes of CD34^＋ cells may predict the pathogenesis and development of type 2 diabetes mellitus complicated by terminal stage nephropathy,in which diabetes mellitus may result in further decrease of CD34^＋ cells.