TNF-R、MCP-1在2型糖尿病肾病患者不同分期中的表达水平及临床意义分析

Expression of TNF-R and MCP-1 in different stages of type 2 diabetic nephropathy and its clinical significance

目的研究肿瘤坏死因子受体(TNFR)、单核细胞趋化蛋白-1(MCP-1)在2型糖尿病肾病患者不同分期中的表达水平及临床意义。方法选择2型糖尿病肾病患者95例,根据患者分期标准分为无蛋白尿组、早期蛋白尿组、临床蛋白尿组3组,同期选择45例健康者作为对照组。收集所有研究对象的外周静脉血,采用酶联免疫吸附法(ELISA)检测血清TNFR-1、TNFR-2和MCP-1水平。结果无蛋白尿组、早期蛋白尿组、临床蛋白尿组患者血清TNFR-1、TNFR-2和尿MCP-1水平均显著高于对照组,且早期蛋白尿组血清TNFR-1、TNFR-2和MCP-1水平明显高于无蛋白尿组,临床蛋白尿组血清TNFR-1、TNFR-2和MCP-1水平明显高于早期蛋白尿组,差异均有统计学意义(P<0.05)。治疗后,无蛋白尿组、早期蛋白尿组、临床蛋白尿组患者血清TNFR-1、TNFR-2和MCP-1水平均显著降低,较治疗前差异均有统计学意义(P<0.05)。结论 2型糖尿病肾病患者每个时期血清TNFR-1、TNFR-2和MCP-1水平明显升高,且随着患者病情程度的加重其水平越高;检测血清TNFR-1、TNFR-2和MCP-1水平可作为判断2型糖尿病肾病病情发展的重要指标。

Objective To study expression of tumor necrosis factor receptor（TNFR）and monocyte chemoattractant protein-1（MCP-1）in different stages of type 2 diabetic nephropathy patients and their clinical significance.Methods 95 patients with chronic renal failure type 2 diabetic nephropathy were selected as research objects.According to staging criteria,those patients were divided into the no albuminuria（n=28）,early proteinuria（n=32）and the clinical proteinuria（n=35）groups.45 healthy persons in the same period were selected as the control group.The peripheral venous blood of all subjects was collected,and ELISA method was used to detect tumor necrosis factor receptor-1,tumor necrosis factor receptor-2 and urinary monocyte chemotactic protein-1 level.Results Serum TNFR-1,TNFR-2 and MCP-1 levels in no albuminuria group,the early albuminuria group,the clinical albuminuria group were significantly higher than those in the control group,and serum TNFR-1,TNFR-2 and MCP-1 levels in early albuminuria group were obviously higher than those in no albuminuria group,serum TNFR-1,TNFR-2 and MCP-1 levels in clinical albuminuria group were obviously higher than those in early albuminuria group,and the differences were statistically significant（P〈0.05）.After treatment,serum TNFR-1,TNFR-2 and MCP-1 were significantly reduced in patients with no proteinuria,early proteinuria,and clinical proteinuria,and the differences were statistically significant（P〈0.05）.Conclusion The levels of TNFR-1,TNFR-2 and MCP-1 in patients with type 2 diabetic nephropathy were significantly higher in each stage,and the levels increased the severity of the disease.The serum TNFR-1,TNFR-2 and MCP-1 levels can be used as an important indicator for the development of diabetic nephropathy.