早期和临床期糖尿病肾脏病患者血清MGO、APN、VEGF水平变化的临床研究

Comparison of serum level of methylglyoxal,adiponectin and vascular endothelial growth factor in patients with diabetic kidney disease at early stage and at clinical stage

目的观察早期和临床期糖尿病肾脏病血清丙酮醛（MGO）、血清脂联素（APN）、血清血管内皮生长因子（VEGF）的差异及演变特点。方法收集2012~2014年就诊于北京中医药大学东直门医院及东区、北京中医药大学第三附属医院,临床诊断为糖尿病肾脏病患者,其中早期糖尿病肾脏病组（早期组）152例,临床期糖尿病肾脏病组（临床期组）56例,2组均接受规范合理的降糖、降压等基础和药物治疗并控制在较合理范围。基线及6个月后分别收集血清并保存,运用酶联免疫吸附法（ELISA）法检测血清MGO、APN、VEGF水平,并观察2组间基线水平和6个月后3指标差异,及组内指标6个月内变化情况。结果与早期组相比,临床期组基线水平及6个月后血清MGO、VEGF水平均升高（P〈0.05）,血清APN无差异;早期组6个月内APN水平有升高（P〈0.05）,MGO、VEGF无显著变化;临床期组6个月内血清MGO、APN、VEGF均无显著变化（P〉0.05）。结论早期糖尿病肾脏病患者血清MGO、VEGF水平升高可一定程度上提示患者病情有向前进展可能,可为早期糖尿病肾脏病患者病情监测提供参考。

Objective To study the differences of serum methylglyoxal（ MGO）,adiponectin（ APN） and vascular endothelial growth factor（ VEGF） in patients with diabetic kidney disease（ DKD） at early stage and at clinical stage. Methods Patients with DKD collected from 2012 to 2014 in the hospitals were grouped by stage（ early stage group： 152 cases,clinical stage group： 56 cases）. All the patients were treated with conventional therapy,including hypoglycemic drugs and antihypertensive drugs. Serum of all patients was collected and detected at the beginning（ baseline） and after six months. Serum MGO,APN and VEGF were measured using ELISA and compared inter-group and intra-group. Results Compared with the early stage group,the levels of serum MGO and VEGF in clinical stage group were higher at the beginning and after six months（ P〈0. 05）,while the level of APN showed no difference. In the early stage group,the level of serum APN got higher after six months than that at the beginning（ P〈0. 05）,with no significant change in MGO,VEGF. There were no significant difference in MGO,APN and VEGF in clinical stage group in six months（ P〉0. 05）. Conclusion The increasing of serum MGO and VEGF which suggested the progression of early DKD,may provide some references for risk assessment of DKD patients at early stage.