糖尿病肾病患者血清纤维化指标与氧化损伤指标的关系探究

Relationship between Serum Fibrosis Indexes and Oxidative Damage Indexes in Patients with Diabetic Nephropathy

目的:探讨糖尿病肾病患者血清纤维化指标和氧化损伤指标的相关性,为临床诊疗提供参考。方法:本研究选取2018年10月-2020年12月本院收治的50例糖尿病肾病患者为观察组,选取同期在本院治疗的50例普通糖尿病患者为对照2组,同期在本院进行体检的50例健康人群为对照1组。比较三组空腹血糖、餐后2 h血糖、糖化血红蛋白、尿素氮、血肌酐、尿酸、24 h尿蛋白、超氧化物歧化酶(SOD)、丙二醛(MDA)、血清过氧化氢酶(CAT)、血清同型半胱氨酸(Hcy)、血管内皮生长因子(VEGF)和转化生长因子β1(TGF-β1)。并对氧化损伤指标及糖尿病肾病患者血清纤维化指标进行相关性分析。结果:三组空腹血糖、餐后2 h血糖、糖化血红蛋白和尿素氮、肌酐、尿酸以及24 h尿蛋白比较,差异均有统计学意义(P<0.05)。观察组和对照2组的空腹血糖、餐后2 h血糖、糖化血红蛋白均高于对照1组,差异均有统计学意义(P<0.05)。观察组的空腹血糖、餐后2 h血糖、糖化血红蛋白均高于对照2组,但差异均无统计学意义(P>0.05)。观察组的尿素氮、肌酐、尿酸以及24 h尿蛋白均高于对照1组和对照2组,差异均有统计学意义(P<0.05)。对照2组的尿素氮、肌酐、尿酸以及24 h尿蛋白均高于对照组1组,但差异均无统计学意义(P>0.05)。三组Hcy、VEGF、TGF-β1水平比较,差异均有统计学意义(P<0.05)。观察组Hcy、VEGF、TGF-β1水平均高于对照1组和对照2组,且对照2组均高于对照1组,差异均有统计学意义(P<0.05)。三组SOD、MDA、CAT比较,差异均有统计学意义(P<0.05)。观察组MDA高于对照1组和对照2组,且对照2组高于对照1组,观察组SOD、CAT均低于对照1组和对照2组,且对照2组均低于对照1组,差异均有统计学意义(P<0.05)。糖尿病肾病患者血清纤维化指标Hcy、VEGF、TGF-β1与MDA均呈正相关,与SOD、CAT均呈负相关(P<0.05)。结论:糖尿病肾病血清纤维化指标与氧化损伤指标有一定的相关性,提示氧化损伤参与了糖尿病肾病的发生发展。

Objective:To investigate the correlation between serum fibrosis indexes and oxidative damage indexes in patients with diabetic nephropathy,and to provide reference for clinical diagnosis and treatment.Method:A total of 50 diabetic nephropathy patients admitted to our hospital from October 2018 to December 2020 were selected as the observation group,50 ordinary diabetic patients treated in our hospital during the same period were selected as the control group 2,and 50 healthy people who underwent physical examination in our hospital during the same period were selected as the control group 1.Fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin,urea nitrogen,serum creatinine,uric acid,24 h-urine protein,superoxide dismutase (SOD),malondialdehyde (MDA),serum catalase (CAT),serum homocysteine (Hcy),vascular endothelial growth factor (VEGF) and transforming growth factor β1 (TGF-β1) were compared among three groups.The correlation between oxidative damage index and serum fibrosis index of diabetic nephropathy was analyzed.Result:There were significant differences in fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin,urea nitrogen,creatinine,uric acid and 24 h urinary protein among three groups (P<0.05).Fasting blood glucose,2 h postprandial blood glucose and glycated hemoglobin in the observation group and control group 2 were higher than those in the control group 1,the differences were statistically significant (P<0.05).Fasting blood glucose,2 h postprandial blood glucose and glycated hemoglobin in the observation group were higher than those in the control group 2,but the differences were not statistically significant (P>0.05).Urea nitrogen,creatinine,uric acid and 24 h urinary protein in the observation group were higher than those in the control group 1 and control group 2,the differences were statistically significant (P<0.05).The urea nitrogen,creatinine,uric acid and 24 h urine protein in the control group 2 were higher than those in the control group 1,but the differences were not statistically significant (P>0.05).There were statistically significant differences in Hcy,VEGF and TGF-β1 among three groups (P<0.05).Hcy,VEGF and TGF-β1 in the observation group were higher than those in the control group 1 and control group 2,and those in the control group 2 were higher than those in the control group 1,the differences were statistically significant (P<0.05).There were statistically significant differences in SOD,MDA and CAT among three groups (P<0.05).MDA in observation group was higher than that in the control group 1 and control group 2,and that in the control group 2 was higher than that in control group 1,SOD and CAT in the observation group were lower than those in the control group 1 and 2,and those in control group 2 were lower than those in the control group 1,the differences were statistically significant (P<0.05).Hcy,VEGF and TGF-β1 were positively correlated with MDA and negatively correlated with SOD and CAT in diabetic nephropathy patients (P<0.05).Conclusion:There is a certain correlation between serum fibrosis indexes and oxidative damage indexes in diabetic nephropathy,suggesting that oxidative damage is involved in the occurrence and development of diabetic nephropathy.