摘要
目的:探讨肾素-血管紧张素-醛固酮系统(RAAS)、血清转化生长因子-β1(TGF-β1)对糖尿病肾病(DN)伴高血压患者肾功能的影响。方法:选择2012年7月~2014年1月我院收治的DN患者87例作为研究对象,根据是否合并高血压分为单纯DN组(n=44)和DN伴高血压组(n=43),同时选取门诊健康体检者40例作为对照组,比较各组对象肾素、血管紧张素Ⅱ(ATⅡ)、醛固酮(ALD)、尿素氮(BUN)、血肌酐(Scr)、肾小球滤过率(e GFR)、尿白蛋白排泄率(UAER)变化情况。结果:与对照组比较,DN伴高血压组和单纯DN组TGF-β1、肾素、ATⅡ、UAER、Scr均升高,e GFR显著降低(P〈0.05);DN伴高血压组Ⅰ期、Ⅱ期、Ⅲ期各指标与单纯DN组比较差异无统计学意义(P〉0.05);DN伴高血压组Ⅳ期、Ⅴ期TGF-β1、肾素、ATⅡ、UAER、Scr、BUN均高于单纯DN组,e GFR均低于单纯DN组,差异有统计学意义(P〈0.05);肾素、ATⅡ与Scr、UAER、TGF-β1呈显著正相关性(r〉0,P〈0.05),与e GFR呈显著负正相关性(r〈0,P〈0.05);TGF-β1与Scr、UAER呈显著正相关性(r〉0,P〈0.05),与e GFR呈显著负正相关性(r〈0,P〈0.05)。结论:在DN伴高血压患者中RAAS和血清TGF-β1水平显著升高,随分期增加,RAAS和血清TGF-β1水平显著增加,二者相互作用可能加重了DN伴高血压患者肾功能损害。
Objective: To investigate the effect of RAAS,TGF- β1 on renal function in diabetic nephropathy with essential hypertension. Methods: 87 cases of DN patients from July to January 2014 in our hospital were selected as the research object,according to whether with hypertension were divided into pure DN group( n = 44) and DN with hypertension group( n = 43),and selected 40 healthy patient as control group,each group object comparison renin,angiotensin Ⅱ( AT Ⅱ),aldosterone( ALD),blood urea nitrogen( BUN),serum creatinine( Scr),glomerular filtration rate( e GFR),urinary albumin excretion rate( UAER) changes.Results: Compared with the control group,DN with hypertension group and pure DN group TGF- β1,renin,AT Ⅱ,UAER,Scr increased,e GFR decreased significantly( P〈0. 05); DN with hypertension group,each index of stage Ⅱ,Ⅲ and DN group have no significant difference( P〉0. 05); DN with high blood pressure group Ⅳ,Ⅴ period TGF- β1,renin,AT Ⅱ,UAER,Scr,BUN were higher than that in group DN,e GFR were lower than those of DN group,the difference was statistically significant( P〈0. 05);renin,ATⅡ and Scr,UAER,TGF- β1 showed significant positive correlation( r〈 0,P〈0. 05),and significantly negative positive correlation with the e GFR( r 〈0,P〈0. 05); and Scr,TGF- β1 UAER showed significant positive correlation( r〈 0,P〈0. 05),and was significantly negative positive correlation with e GFR( r 〈0,P〈0. 05). Conclusion: In DN with RAAS and serum TGF- in the patients with TGF- β1 levels significantly increased,with the increase of staging,RAAS and serum TGF- β1 level increased,the interaction between the two could increase DN damage associated with renal function in patients with essential hypertension.
出处
《中国中西医结合肾病杂志》
2015年第3期219-221,共3页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
四川省医学会基金资助项目(No.川学会医[2013]63号)