糖尿病慢性肾脏疾病患者血清上皮衍生因子水平变化及其临床意义

Changes of serum PEDF level in CKD patients and its clinical significance

目的探讨血清上皮衍生因子(PEDF)水平检测在糖尿病慢性肾脏疾病(CKD)的临床意义。方法选取2014年6月至2015年12月该院确诊的140例CKD患者,根据患者的尿蛋白排泄率分为:尿蛋白正常组77例(尿蛋白排泄率小于20μg/min)、尿蛋白阳性组63例(≥20μg/min),另选择该院同期50例健康体检者作为健康对照组,比较3组研究对象PEDF水平并分析其与患者血糖、肾功能等指标的相关性。结果尿蛋白正常组和尿蛋白阳性组患者血清PEDF水平均显著高于健康对照组,差异有统计学意义(P<0.05),尿蛋白阳性组患者血清PEDF水平高于尿蛋白正常组,差异有统计学意义(P<0.05);尿蛋白正常组和尿蛋白阳性组患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血肌酐(Scr)、尿素氮(BUN)水平均显著高于健康对照组,肾小球滤过率(GFR)均低于健康对照组,差异均有统计学意义(P<0.05),尿蛋白阳性组患者FPG、HbA1c、Scr、BUN水平高于尿蛋白正常组,GFR低于尿蛋白正常组,差异有统计学意义(P<0.05);血清PEDF水平与Scr、BUN呈显著的正相关性(P<0.05),血清PEDF水平与GFR呈显著的负相关性(P<0.05)。结论 CKD患者血清PEDF水平变化可能与患者肾损伤具有一定的相关性。

Objective To investigate serum epithelial derived factor（PEDF） levels in the role of diabetic patients with chronic kidney disease（CKD）. Methods 140 cases of CKD patients in our hospitalFrom June 2014 to December 2015 were selected. The patients were divided into normal urine protein group 77 cases（urinary protein excretion rate 〈20μg/min） and urine protein positive group 63 cases（urinary protein excretion rate of more than 20 μg/min） according to urinary albumin excretion rate, another 50 healthy cases were selected as the healthy group,the PEDF levels of three groups were compared and the relationship of other laboratory indexes were analyzed. Results Serum PEDF level of normal urine protein group and urine protein positive group were significantly higher than the healthy group, the difference was statistically s ignificant（P〈0.05）, serum PEDF of urine protein positive group were significantly higher than the normal urine protein group, the difference was statistically significant（P〈0.05）;FPG. HbA1c.Scr and BUN levels of normal urine protein group and urine protein positive group were significantly higher than the healthy group,however the GFR level was lower than the healthy group, the differences were statistically significant （P〈0.05）; FPG,HbAIc.Scr and BUN levels of urine protein positive group were significantly higher than normal urine protein group, and GFR level was lower than normal urine protein group, the differences was statistically significant（P〈0.05） ;There was a significant positive correlation between serum PEDF levels and Scr,BUN（P〈0.05）, and a significant negative correlation with serum PEDF level in patients with GFR（P〈0.05）. Conclusion The change of serum PEDF level in CKD patients may be related to the renal function impairment.