血清单核细胞趋化蛋白-1与糖尿病肾病进展的关系

Risk factors of serum MCP-1 and DN progression

目的分析血清单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)与糖尿病肾病(diabetic nephropathy,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月至2020年10月广州市第十二人民医院收治的80例DN患者作为研究对象;患者均行血液透析治疗;检测患者血中MCP-1水平并检测患者血中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,且差异有显著性(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,且差异有显著性(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正相关(P<0.05);病情较轻者血中总胆固醇、甘油三酯、低密度脂蛋白(low density lipoprotein C,LDL-C)、糖化血红蛋白、C肽、血浆比黏度、红细胞电泳率、红细胞沉降率、红细胞比容、血小板黏附率水平明显低于病情严重者,高密度脂蛋白(high density lipoprotein C,HDL-C)明显高于病情严重者,差异有显著性(P<0.05);DN患者血中MCP-1、总胆固醇、甘油三酯、HDL-C、LDL-C、糖化血红蛋白、C肽、血浆比黏度、红细胞电泳率、红细胞沉降率、红细胞比容、血小板黏附率是影响患者病情严重程度的独立性威胁因素(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现显著正相关,且患者血脂代谢、血液流变学、MCP-1是影响DN病情进展的独立性危险因素。

Objective To analyze the relationship between serum monocyte chemotactic 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.Method 80 patients with DN in our 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 the blood of patients were detected,and the blood lipid metabolism and hemorheology indexes were detected.Result 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 specific viscosity,erythrocyte electrophoresis rate,erythrocyte sedimentation rate,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 and(total bile duct solid)in patients with DN were significantly higher than those in patients with severe disease;triglyceride,HDL-C,LDL-C,glycosylated hemoglobin,C-peptide,plasma specific viscosity,erythrocyte electrophoresis rate,erythrocyte sedimentation rate,hematocrit and platelet adhesion rate were independent risk factors affecting the severity of the disease(P<0.05).Conclusion serum MCP-1 was positively correlated with the severity of the disease and the therapeutic effect of hemodialysis in patients with DN.Blood lipid metabolism,hemorheology and MCP-1 were independent risk factors for the progression of DN.