血清可溶性CD146水平在早期糖尿病肾病诊断中的作用

Diagnostic Significance of Serum Soluble CD146 Level in Early-stage Diabetic Nephropathy

目的探讨血清可溶性CD146(s CDl46)水平在早期糖尿病肾病(DN)诊断中的作用。方法选用SPF级SD雄性大鼠32只,随机分为2组:空白组(C组)和模型组(DN组),每组16只。造模开始至实验结束,每周1次测量大鼠体质量、血糖,收集24 h尿液测定尿白蛋白、尿α1徽球蛋白(AIM)、尿转铁蛋白(TRU)、尿糖定性、尿N-乙酰-β-D-氨基葡萄糖苷酸(NAG)等指标。分别于成模第1天、第3周2个时间点,测定血肌酐(Scr)、血尿素氮(BUN)、s CD146水平,并计算大鼠肾质量/体质量比(RW/BW)。肾组织PAS染色观察肾皮质,计算肾小球系膜面积(MMA)。结果 DN组大鼠尿白蛋白、AIM、TRU、NAG指标明显高于C组(均P<0.01)。模型制备成功后第3周Scr、BUN指标DN组均高于C组,但差异均无统计学意义(P>0.05)。模型制备成功后第1天、第3周模型组血清s CD146水平均较C组增高(均P<0.05)。RW/BW以及肾组织PAS染色结果显示,DN组RW/BW以及MMA均高于C组(P<0.01)。结论与C组比较,DN组中血清s CD146水平较早较快增加,s CD146能够更敏感地反映肾脏损害程度,对监测DN的发生与发展有重要临床意义。

Objective To investigate serum soluble CD146 （sCD146） level in early-stage diabetic nephropathy. Methods Thirty-two SPF-class SD rats were randomly divided into 2 groups as follows ： a control group （C group ,n = 16） and a model group （DN group ,n = 16）. Serum creatinine （Scr）, blood urea nitrogen （BUN）, sCD146 level, and renal weight-to-body weight ratio （RW/BW） were estimated at the first day （D 1 ） and third week （W3） after modelling. Periodic acid-Schiff staining was used for observing the renal cortex and calculating the renal glomerular mesangial membrane area （MMA）. Results The serum sCD146 level was significantly higher in the DN group at D1 and W3 （P 〈 0.05） compared with that in the C group. RW/BW and MMA were significantly higher in the DN group than in the C group （P 〈 0.01）. Conclusion Serum sCD146 level reacts to increases much sooner and faster in the DN model,which could be used as a sensitive diagnostic index to reflect the severity of early renal damage.