糖尿病肾病患者血清hs-CRP、IL-6、MCP-1及AngptI4水平变化特点及临床意义

Changes and Clinical Significance of Serum hs-CRP、IL-6、MCP-1 and Angpt I4 Levels in Patients with Diabetic Nephropathy

目的探讨血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、单核细胞趋化蛋白1(MCP-1)、血管生成素样蛋白4(Angpt I4)在糖尿病肾病(DN)患者中的变化及其意义。方法选取我院2016年2月至2018年2月确诊的2型糖尿病患者200例,其中单纯T2DM患者99例(T2DM组)、早期DN患者66例[早期DN组,尿微量白蛋白排泄率(UAER)30mg^300mg/24h]、临床期DN患者35例(临床DN组,UAER范围>300mg/24h),同期健康体检对象60例(对照组),对比各组的血清hs-CRP、IL-6、MCP-1及Angpt I4水平,并分析hs-CRP、IL-6、MCP-1及Angpt I4与DN患者肾功能指标的关系。结果T2DM组、早期DN组、临床期DN组的hs-CRP、IL-6水平显著的高于对照组,T2DM组、早期DN组、临床期DN组的Angpt I4水平显著的低于对照组,T2DM组、早期DN组的MCP-1水平高于对照组,差异有统计学意义(P<0.05);早期DN组、临床期DN组的hs-CRP、MCP-1水平显著的高于T2DM组,临床期DN组的IL-6高于T2DM组和早期DN组,临床期DN组的Angpt I4低于T2DM组和早期DN组,差异有统计学意义(P<0.05);临床期DN组的hs-CRP、IL-6、MCP-1均高于早期DN组,临床期DN组的Angpt I4低于早期DN组,差异有统计学意义(P<0.05);DN患者的血清hsCRP、IL-6、MCP-1水平与Scr、BUN呈显著的正相关关系P<0.05),与Angpt I4呈显著的负相关关系P<0.05)。结论DN患者的血清hs-CRP、IL-6、MCP-1水平升高、Angpt I4水平降低,并且与肾功能损害程度具有一定的相关性。

Objective To investigate the changes and significance of high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),monocyte chemoattractant protein 1(MCP-1),and angiopoietin-like protein 4(Angpt I4)in patients with diabetic nephropathy(DN).Methods 200 patients with type 2 diabetes diagnosed in our hospital from February 2016 to February 2018 were selected,including 99 patients with T2DM alone(T2DM group)and 66 patients with early DN[early DN group,urinary albumin excretion rate(UAER).30 mg^300 mg/24 h],35 patients with clinical DN(clinical DN group,UAER range>300 mg/24 h),60 healthy subjects in the same period(control group).The serum hs-CRP,IL-6,MCP-1 and Angpt I4 levels were compared between the groups,and the relationship between hs-CRP,IL-6,MCP-1 and Angpt I4 and renal function indexes of DN patients were analyzed.Results The levels of hs-CRP and IL-6 in the T2DM group,the early DN group,and the clinical DN group were significantly higher than those in the control group.The level of Angpt I4 in the T2DM group,the early DN group,and the clinical DN group was significantly lower than that in the control group.The level of MCP-1 in the T2DM group and the early DN group was higher than that in the control group.And the differences were statistically significant(P<0.05).The levels of hs-CRP and MCP-1 in the early DN group and the clinical DN group were significantly higher than those in the T2DM group.The IL-6 in the DN group was higher than that in the T2DM group and the early DN group.The Angpt I4 in the DN group was lower than the T2DM in the clinical stage.And the differences were statistically significant(P<0.05).The hs-CRP,IL-6 and MCP-1 in the DN group were higher than those in the early DN group.The Angpt I4 in the DN group was lower than that in the early DN group(P<0.05).And the differences were statistically significant(P<0.05).Serum hs-CRP,IL-6 and MCP-1 levels were positively correlated with Scr and BUN in patients with DN(P<0.05),and negatively correlated with Angpt I4(P<0.05).Conclusion Serum hs-CRP,IL-6,MCP-1 and Angpt I4 levels were decreased in patients with DN,and there was correlation with the degree of renal impairment.