·糖尿病慢性肾脏疾病·

　　血清半乳糖凝集素-3在糖尿病慢性肾脏疾病中应用的观察

　　万枫 毛卫林 娄域峰

　　【摘要】 目的 探讨半乳糖凝集素-3(Gal-3)在糖尿病肾病中的临床价值。 方法 选取浙江大学医学院附属第一医院患者180例，分为无肾病糖尿病(DM)组55例,糖尿病肾病(DN)组66例和非糖尿病肾病(NDN)组59例，另选取60名健康成年人作为对照(NC)组,并于入院第1天进行肾功能、HbA1c、血清Gal-3及尿四项蛋白的检测,留取24 h尿进行24 hUAlb分析。 结果 DN组与DM组相比，糖尿病持续时间(10.3±5.2 vs 4.7±2.7)年, HbA1c(7.5±3.2% vs 6.8±2.8%)，24 hUAlb (4.39±1.45 vs 0.22±0.12) g/24 h，Gal-3水平(12.5±3.7 vs 6.7±3.0 )ng/ml以及肾功能、尿四项蛋白比较差异均有统计学意义(P<0.05);DN组与NDN组相比，糖尿病持续时间(10.3±5.2 vs 0)年, HbA1c(7.5±3.2% vs 4.5±1.4%),24 UAlb (4.39±1.45 vs 2.78±0.76 ) g/24 h及Gal-3水平(12.5±3.7 vs 5.5±2.4)ng/ml比较差异均有统计学意义(P<0.05)。DN患者血清Log Gal-3与Log Glu及年龄无相关性，与LogUAlb和糖尿病持续时间呈正相关(r=0.621、0.761, P<0.01)。多因素Logistic回归分析结果显示，糖尿病持续时间、HbA1c、Gal-3与DN独立相关。 结论 Galectin-3能很好地反映DN肾小球受损程度，并间接反映糖尿病持续时间，具有临床应用价值。

　　【关键词】糖尿病慢性肾脏疾病;半乳糖凝集素-3(Galectin-3)

The role of serum galectin-3 in patients with diabetic nephropathy Wan Feng, Mao Wei-lin, Lou Yu-feng. Department of Clinical Laboratory, Urumqi Municipal Maternal and Child Health Epidemic Prevention Hospital, Xinjiang 830001, China.

　　【Abstract】 Objective To investigate the clinical value of galactose-3 (Gal-3) in diabetic nephropathy. Methods One hundred and eighty patients, including 66 with diabetic nephropathy, 59 without diabetic nephropathy, 55 patients with diabetes mellitus, and 60 healthy controls were enrolled in the study. In all subjects, a blood sample was collected at admission to examine renal function, fasting plasma glucose, glycosylated hemoglobin, serum gal-3 and urine four protein, and 24 hour urine was taken for the analysis on 24 hUAlb. Results The diabetic nephropathy patients had significantly higher Gal-3 (12.5±3.7 vs 5.5±2.4, 12.5±3.7 vs 6.7±3.0)ng/ml, all P<0.05, HbA1c (7.5±3.2% vs 4.5±1.4%, 7.5±3.2% vs 6.8±2.8%), all P<0.05, diabetes mellitus duration (10.3±5.2 vs 0, 10.3±5.2 vs 4.7±2.7) years, all P<0.05, and 24 hUAlb (4.39±1.45 vs 2.78±0.76, 4.39±1.45 vs 0.22±0.12) g/24h, all P<0.05, at admission compared with non diabetic nephropathy and diabetes mellitus patients. In the patients with diabetic nephropathy, the Log Gal-3 was without correlation with Log Glu and age, while positively correlated with Log UAlb and the diabetes mellitus duration (r=0.621, 0.761, P<0.01). Multivariate analysis demonstrated that the diabetes mellitus duration, Hb1Ac, and Gal-3 were independent predictors for diabetic nephropathy (all P<0.05). Conclusion Gal-3 can reflect well the degree of glomerular damage of diabetic nephropathy, and indirectly reflect the diabetic duration. It has clinical value.

　　【Key Words】Diabetic nephropathy; Galectin-3 (Gal-3)