2型糖尿病肾病VEGF与VEGF-A的表达及治疗后的变化

Levels of Serum VEGF and VEGF-A in Type 2 Diabetic Nephropathy and the Changes after Treatment

目的 :探讨血清中血管内皮生长因子(VEGF)及其亚型VEGF-A的水平与2型糖尿病肾病之间的关系,探讨依那普利对肾脏的保护作用是否与VEGF、VEGF-A血清水平相关。方法 :选取104例2型糖尿病患者,按照尿白蛋白水平分为A正常白蛋白尿组(35例)、B微量白蛋白尿组(40例)、C大量白蛋白尿组(29例),另选健康人作为D健康对照组(30例),检测各组血清VEGF及VEGF-A水平;将B组随机分为两组各20例,B1组口服依那普利作为治疗组,B2组行常规治疗作为对照组,检测治疗3个月后两组VEGF及VEGF-A的水平。结果 :2型糖尿病肾病各组患者中血清VEGF,特别是VEGF-A水平均较健康对照组明显升高,且C组>B组>A组;相关性分析:VEGF和VEGF-A与尿微量白蛋白、血肌酐呈正相关,与估算的肾小球滤过率呈负相关;依那普利治疗后患者血清VEGF和VEGF-A较治疗前明显下降。结论 :血清VEGF、VEGF-A可及时反映2型糖尿病肾病疾病进展,其中VEGF-A的敏感性及特异性更高,推测VGEF-A可作为早期诊断及监测2型糖尿病肾病疗效的最重要指标之一。

Objective To investigate the relationships between serum vascular endothelial growth factor(VEGF), VEGF-A and Type 2 Diabetic Nephropathy. To find out Whether the protective effect of enalapril on the kidney are related to serum concentrations of VEGF and VEGF-A. Methods Total 104 type 2 diabetes inpatients were selected. According to their urinary albumin, were divided into normal albuminuria group(group A, n=35), microalbuminuria group(group B, n=40), macroalbuminuria group(group C, n=29), and 30 healthy individuals were enrolled in this study as the healthy control group(group D). Detect the serum concentrations of VEGF and VEGF-A. Group B patients were randomly divided into two groups, B1 were treated with enalapril as the treatment group(n=20), B2 were treated with routine treatment as the control(n=20). Results The serum levels of VEGF and VEGF-A in diabetic nephropathy were significantly higher than those in the healthy control group, group C > group B > group A. Correlation analysis shows that VEGF, VEGF-A has a positive correlation with urinary albumin and serum creatinine, and a negative correlation with estimated glomerular filtration rate. After three months of treatment, VEGF and VEGF-A was Significantly lower in treatment group. Conclusion Serum VEGF, VEGF-A might reflect progress of type 2 diabetes diabetic nephropathy. VEGF-A has higher sensitivity and specificity than VEGF in this study. Serum VEGF-A were likely recommended as indicators for early diagnosis and monitors of disease progression in type 2 diabetic nephropathy.