血清单核细胞趋化蛋白1与糖尿病肾病患者病情严重程度和血液透析治疗效果的关系及糖尿病肾病病情进展的危险因素分析

The Relationship Among Serum Monocyte Chemoattractant Protein-1 and Severity of Diabetic Nephropathy and Effect of Hemodialysis and the Risk Factors of Diabetic Nephropathy Progression

目的探讨血清单核细胞趋化蛋白1(MCP-1)与糖尿病肾病(DN)患者病情严重程度和血液透析治疗效果的关系及DN病情进展的危险因素。方法选择2019年1月—2020年10月收治的80例DN患者作为研究对象;患者均行血液透析治疗;检测DN患者血中MCP-1水平及血脂代谢和血液流变学指标。结果DN病情较轻患者血中MCP-1水平明显低于病情严重者,且差异有统计学意义(P<0.05);DN患者采用血液透析治疗疗效有效者血中MCP-1水平明显低于疗效不佳者,且差异有统计学意义(P<0.05);DN患者血中MCP-1水平与患者病情严重程度和血液透析疗效呈显著性正相关关系(P<0.05);病情较轻者患者血中总胆固醇、甘油三酯、低密度脂蛋白胆固醇、糖化血红蛋白、C肽、血浆黏度、红细胞电泳率、血沉、红细胞压积、血小板黏附率水平明显低于病情严重者,高密度脂蛋白胆固醇明显高于病情严重者,且差异均有统计学意义(P<0.05);DN患者血中MCP-1、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白、C肽、血浆黏度、红细胞电泳率、血沉、红细胞压积、血小板黏附率是影响患者病情严重程度的独立危险因素(P<0.05)。结论DN患者血清MCP-1与病情严重程度和血液透析治疗疗效均呈显著正相关关系,且患者血脂代谢、血液流变性、MCP-1是影响DN病情进展的独立性危险因素。

Objective To explore the relationship between serum monocyte chemoattractant protein-1(MCP-1)and the severity of diabetic nephropathy(DN)and the effect of hemodialysis,and the risk factors for the progression of DN.Methods 80 patients with DN in Xiayi People's Hospital from January 2019 to October 2020 were selected as the research objects,all patients were treated with hemodialysis,the levels of MCP-1 in DN patients were detected,and the blood lipid metabolism and hemorheological indexes were detected.Results The level of MCP-1 in patients with mild DN was significantly lower than that in patients with severe DN,and the difference was statistically significant(P<0.05).The level of MCP-1 in patients with effective hemodialysis was significantly lower than that in patients with poor hemodialysis,and the difference was statistically significant(P<0.05).The level of MCP-1 in patients with DN was positively correlated with the severity of the disease and the effect of hemodialysis.The levels of total cholesterol,triglyceride,LDL-C,glycosylated hemoglobin,C-peptide,plasma viscosity,erythrocyte electrophoresis rate,erythrocyte sedimentation rate and hematocrit,platelet adhesion rate in patients with mild disease were significantly lower than those in patients with severe disease,while HDL-C was significantly higher than those in patients with severe disease,and the differences were statistically significant(P<0.05).The levels of MCP-1,total cholesterol,triglyceride,HDL-C,LDL-C,glycosylated hemoglobin,C-peptide,plasma viscosity,erythrocyte electrophoresis rate,erythrocyte sedimentation rate,hematocrit and platelet adhesion rate in patients with DN were independent risk factors affecting the severity of the disease(P<0.05).Conclusion Serum MCP-1 is positively correlated with the severity of the disease and the therapeutic effect of hemodialysis in patients with DN.Blood lipid metabolism,hemorheological indexes and MCP-1 are independent risk factors for the progression of DN.