·糖尿病性肾脏疾病·

　　刘海霞 刘奔 刘丹丹 孙李永眷 李晶 张萍 孟秀香 苏本利

　　基金项目：辽宁省自然科学基金资助项目(20062160);大连市科学技术基金计划项目(2011J21DW018)

　　作者单位：116027大连，大连医科大学附属第二医院内分泌科(刘海霞、孙李永眷、李晶、张萍、苏本利);大连医科大学临床诊断中心(刘奔、刘丹丹、孟秀香)

　　通讯作者：苏本利, E-mail : mxxsu@sina.com

　　【摘要】目的探讨血清单核细胞趋化蛋白1(MCP-1)、肿瘤坏死因子α(TNF-α)、高敏C反应蛋白(hsC-RP)、血浆纤溶酶原激活物抑制物1(PAI-1)、脂多糖(LPS)及晚期糖基化指数(AGI)水平与T2DM早期肾病的关系。方法78例糖尿病患者根据即时尿标本的白蛋白/肌酐(UAlb/Cr)水平分为:正常白蛋白尿(NUAlb)组(n=40)、微量白蛋白尿(MUAlb)组(n=38)。观察各组患者MCP-1、TNF-α、hsC-RP、PAI-1、LPS、AGI水平的变化,并与健康对照(NC)组(n=40)进行比较。结果NUAlb、MUAlb组的MCP-1、TNF-α、hsC-RP、PAI-1、LPS及AGI水平均明显高于NC组(P<0.01);MUAlb组的上述炎症标志物水平明显高于NUAlb组(P<0.05)。将性别、年龄、BMI、基线HbA1c、是否合并高血压、血脂紊乱作为协变量控制后，UAlb/Cr与MCP-1、LPS、TNF-α、PAI-1、hsC-RP、AGI作偏相关分析，结果呈显著正相关(r=0.69，0.61,0.64,0.76,0.67,0.62，P均<0.01)。结论早期检测血清MCP-1、TNF-α、hsC-RP、PAI-1、LPS及AGI水平的变化,对于糖尿病性肾脏疾病的早期诊断和及时治疗有重要意义。

　　【关键词】糖尿病性肾脏疾病;炎症标志物

　　doi:10.3969/j.issn.1006-6187.2012.02.006

　　Clinical significance of detection of serum MCP-1,TNF-α,hsC-RP,PAI-1,LPS and AGI for diagnosis of early type 2 diabetic nephropathyLIU Hai-xia,LIU Ben, LIU Dan-dan,et al. Department of Endocrinology, The Second Affiliated Hospital of Dalian Medical University, Diagnostics Laboratory Center, Dalian Medical University, Dalian 116027,China

　　Corresponding author: SU Ben-li, E-mail: mxxsu@sina.com

　　【Abstract】ObjectiveTo evaluate the clinical significance of serum MCP-1,TNF-α,hsC-RP,PAI-1,LPS and AGI in diagnosis of early type 2 diabetic nephropathy. Methods78 diabetic patients were divided into two groups based on urinary albumin-creatinine ratio: group A without albuminuria (UALB/Cr<30μg/mg, n=40), group B with mircroalbuminuria (UALB/Cr 30-300μg/mg, n=38). Serum MCP-1, TNF-α，hsC-RP，PAI-1，LPS，AGI levels were measured with commercial ELISA kits. ResultsSerum levels of MCP-1，TNF-α，hsC-RP，PAI-1，LPS and AGI were significantly higher in T2DM patients than in healthy controls (P<0.01). Serum levels of MCP-1，TNF-α，hsC-RP，PAI-1，LPS and AGI were significantly higher in T2DM patients with microalbuminuria than in T2DM patients without albuminuria (P<0.05). ConclusionDetection of serum MCP-1，TNF-α，hsC-RP，PAI-1，LPS and AGI levels might be useful for diagnosing early diabetic nephropathy, monitoring the progress, of the disease process, and determining the strategy of treatment.

　　【Key words】Diabetic kidney disease;Inflammatory biomarker