糖尿病肾病患者血清炎性因子、vWf、VEGF及黏附分子水平变化及意义

Changes and detection significance of serum inflammatory factors,vWf,VEGF and adhesion molecules in patients with diabetic nephropathy

目的:探讨糖尿病肾病(DN)患者血清炎性因子、血管性血友病因子(vWf)、血管内皮生长因子(VEGF)及黏附分子水平变化及其检测意义。方法:158例T2DM患者依据尿白蛋白排泄率(UAER)分为T2DM组(单纯糖尿病组,n=52)与DN组(糖尿病肾病组,n=106),后者又可分为微量白蛋白尿组(n=54)和大量白蛋白尿组(n=52);同时选取同期的健康体检者50例作为对照组,比较4组间的血清炎性因子超敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α),血管性血友病因子(vWf)、血管内皮生长因子(VEGF)与黏附分子(sVCAM-1、sICAM-1和E-选择素)水平。结果:T2DM组与DN组患者hs-CRP、IL-6、TNF-α、vWf、VEGF、sVCAM-1、sICAM-1和E-选择素水平均显著高于对照组(P<0.05),且DN组显著高于T2DM组,差异有统计学意义(P<0.05);DN组中,与微量白蛋白尿组相比,大量白蛋白尿组的hs-CRP、IL-6、TNF-α、vWf、VEGF、sVCAM-1、sICAM-1和E-选择素水平均显著升高,差异有统计学意义(P<0.05)。结论:在DN的发生及发展过程中,血清炎性因子、vWf、VEGF与黏附分子等均可能起着重要的作用,其指标水平检测对病情的评估具有重要价值。

Objective：To investigate the changes of serum inflammatory factors,von Willebrand factor（vWf）,vascular endothelial growth factor（VEGF）and adhesion molecule levels in diabetic nephropathy patients（DN）,and their significance in the detection of diabetic nephropathy.Methods：According to urinary albumin excretion rate（UAER）,158 cases of diabetic patients were divided into T2 DM group（simple diabetes group,n=52）and DN group（diabetic nephropathy group,n=106）.Patients in the DN group were then divided into microalbuminuria group（n=54）and macroalbuminuria group（n=52）;at the same time,50 healthy subjects were selected as control group.The levels of serum inflammatory factors（hs-CRP,IL-6and TNF-α）,vWf,VEGF and adhesion molecules（sVCAM-1,sICAM-1and E-selectin）between the four groups were compared.Results：The levels of hs-CRP,IL-6,vWf,VEGF,TNF-α,sVCAM-1,sICAM-1and E-selectin in the T2 DM group and DN group were significantly higher than those in the control group（P〈0.05）,and the above levels in DN group were significantly higher than those in T2 DM group（P〈0.05）.In the DN group,compared with microalbuminuria group,the levels of hs-CRP,IL-6,vWf,VEGF,TNF-α,sVCAM-1,sICAM-1and E-selectin in the macroalbuminuria group were significantly increased（P〈0.05）.Conclusions：Serum inflammatory factors,vWf,VEGF and adhesion molecules may play an important role in the course of the development of DN.And they have great value to the assessment of the disease.