·糖尿病慢性肾脏疾病·

　　【摘要】 目的 探讨不同时期糖尿病慢性肾脏疾病(CKD)患者血清可溶性CD40配体 (sCD40L)水平变化。 方法 根据UAER将93例T2DM患者分为正常白蛋白尿(NA)组38例，微量白蛋白尿(MA)组29例和临床蛋白尿(CP)组26例，另选25名健康体检者作为NC组。采用酶联免疫吸附法(ELISA)测定各组血清sCD40L水平。 结果 (1)T2DM患者血清sCD40L水平较NC升高，且随UAER升高而升高。(2)sCD40L水平与病程、HbA1c、TC呈正相关性(β=5.95、6.64、17.08，P<0.05)，与HDL-C、APOA呈负相关性(β=-49.12、-46.56，P<0.05)。(3)sCD40L、LDL-C、SBP为CKD独立危险因素(OR=1.21、1.61、1.35，P<0.05)。 结论 CKD患者血清CD40L水平升高，它是T2DM并发CKD的独立相关因素。

　　【关键词】 糖尿病慢性肾脏疾病;血清可溶性CD40配体

The clinical significance of the level of serum soluble CD40 ligand in T2DM patients with chronic kidney disease JIN Xiu-ping, GUO Wei-na, WEI Jian-fen. Department of Endocrinology, Affiliated Hospital of Hebei United University, Tangshan 063000, China

　　【Abstract】 Objective To investigate the changes of the level of serum soluble CD40 ligand (sCD40L) of T2DM patients with chronic kidney disease (CKD) in different stages and its clinical significance. Methods This study included 93 T2DM patients. According to UAER, these patients were divided into three groups: 38 cases in normal albuminuria (NA) group, 29 cases in microalbuminuria (MA) group, and 26 cases in clinical urine protein (CP) group. Additionally, 25 people for healthy examination were selected as NC group.Serum sCD40L levels were measured by the ELISA method. Results (1). The sCD40L level was significantly higher in the T2DM patients than in the NC group, and it was increased with the increment of UAER. (2).The sCD40L level showed a positive correlation with the course, HbA1c, and TC (β=5.95, 6.64, 17.08, P<0.05)，and a negative correlation with HDL-C and APOA (β=-49.12, -46.56, P<0.05). (3). sCD40L,LDL-C, and SBP were independent risk factors for CKD (OR=1. 21, 1.61, 1.35, P<0.05). Conclusion The level of sCD40L in the T2DM patients with CKD is higher and it is an independent factor for the development of CKD.

　　【Key words】Chronic kidney disease (CKD); Serum soluble CD40 (sCD40L)