·糖尿病肾脏疾病·

　　【摘要】 目的 探讨不同时期糖尿病慢性肾脏疾病(CKD)患者血浆心钠素(ANP)水平变化及其临床意义。 方法 选取T2DM患者93例，根据UAER分为单纯糖尿病(DM)组30例、CKD Ⅲ期(CKD Ⅲ)组31例及CKD Ⅳ期(CKD Ⅳ)组32例，另选健康体检者30名作为正常对照(NC)组。采用ELISA测定各组血浆ANP水平。 结果 (1)DM、CKD Ⅲ和CKD Ⅳ组ANP水平均高于NC组，且随UAER增加而增加[(280.89±43.66) vs (356.87±45.45) vs (414.95±57.52) vs (164.09±36.64) ng/l, P<0.05];(2)ANP水平与病程、HbA1c、FPG、TG、BUN、Cr呈正相关(r=0.77、0.82、0.73、0.71、0.80、0.74， P均<0.05)，与HDL-C呈负相关(r=-0.68，P<0.05)。 结论 血浆ANP与CKD患者UAER正相关，FBG、HbA1c、BUN、Cr和TG是血浆ANP的独立正相关因子。

　　【关键词】 糖尿病，2型：糖尿病慢性肾脏疾病;血浆心钠素

　　【Abstract】 Objective To explore the level change of plasma atrial natriuretic peptide(ANP) in type 2 diabetic patients with chronic kidney disease and its clinical significance . Methods 93 patients with type 2 diabetes were divided into three groups according to the urinary albumin excretion rate (UAER): simple diabetes (DM)group , CKD Ⅲ and CKD Ⅳ group ,with 30 cases ,31 cases ,32 cases respectively. Another 30 healthy subjects were included as normal control (NC) group . The serum level of ANP were tested by ELISA . Results (1) The serum levels of ANP were higher in DM, CKD Ⅲ, CKD Ⅳ group than in NC group, and ANP level increases as UAER increases [(280.89±43.66) vs (356.87±45.45) vs (414.95±57.52) vs (164.09±36.64) ng/l, P<0.05].(2) Serum levels of ANP were positively correlated with disease course, HbA1c, FPG, TG, BUN, Cr (r=0.77，0.82，0.73，0.71，0.80，0.74， all P<0.05), while negatively correlated with HDL-C (r = -0.68,P<0.05). Conclusion Serum levels of ANP were positively correlated with UAER in patients with with chronic kidney disease ，FBG,HbA1c,BUN,Cr and TG is independent positively correlated factors for serum ANP.

　　【Key words】 Diabetes mellitus ,type 2:Chronic kidney disease in diabetes;Atrial natriuretic peptide