糖尿病肾病患者血清血管内皮生长因子和色素上皮衍生因子水平变化

Change and Significance of Serum Vascular Endothelial Growth Factor and Pigment Epithelium-derived Factor in Type 2 Diabetic Nephropathy

目的:探讨2型糖尿病肾病(DN)患者血清血管内皮生长因子(VEGF)和色素上皮衍生因子(PEDF)水平变化及其在DN发生发展中的意义。方法:将175例研究对象分为正常对照组(NC组,n=35)、单纯糖尿病组(T2DM组,n=35)、DNⅢ期组(Ⅲ组,n=40)、DNⅣ期组(Ⅳ组,n=35)、DNⅤ期组(Ⅴ组,n=30)。采用酶联免疫法检测各组血清VEGF及PEDF水平并分析二者相关性,同时测定全血糖化血红蛋白(HbA1c)、血浆纤维蛋白原(Fib)、血肌酐(Cr)及24h尿微量白蛋白排泄率(UAER),并行UAER危险因素的多元回归分析。结果:五组血清PEDF、VEGF水平差异有统计学意义(P<0.01),各病例组水平均高于NC组,且Ⅴ组>Ⅳ组>Ⅲ组,差异均有统计学意义(P<0.01),T2DM组与Ⅲ组比较差异无统计学意义(P>0.05)。研究对象血清VEGF与PEDF水平呈直线相关(r=0.847,P<0.01)。血清VEGF、HbA1c是UAER的独立危险因素(R2=0.430)。结论:VEGF和PEDF可能参与了DN的发生发展。

Objective： To investigate the change of vascular endothelial growth factor （VEGF） and pigment epithelium-derived factor （PEDF） in the development of diabetic nephropathy. Method： 175 subjects were divided into control group（n = 35）, T2DM group （n： 35 ）, DN III stage group （ III group, n = 40）, IV stage group （ IV group, n = 35） and stage group（ V group,n= 30）. ELISA was used to detect the serum VEGF and PEDF. Blood lipid, fasting plasma glucose,insulin, HBAlc, blood creatinine and fibrinogen were simultaneously determined. Results： The serum level of PEDF, VEGF and Fib increased gradually in the five groups and there were significant difference. Except T2DM group with III group, there were significant difference between other groups. VEGF and PEDF showed linear correlation（r=0. 847 ,P〈0.01）. VEGF, HbAlc were significant independent determinants of UAER（R^2= 0. 430）. Conclusion： VEGF and PEDF may involve in the development of diabetic nephropathy.