糖尿病患者血清层粘连蛋白水平及其影响因素的探讨

目的：为探讨血清层粘连蛋白（Ｌａｍｉｎｉｎ,ＬＮ）与糖尿病微血管病变的关系,研究糖尿病患者血清ＬＮ的影响因素。方法：用放免法测定７６例２型糖尿病患者和３８例正常对照者的血清ＬＮ浓度。结果：糖尿病患者血清ＬＮ显著高于正常对照（分别为１６８．７６±２７．８４ｎｇ／ｍｌ和１４９．０９±２８．８４ｎｇ／ｍｌ,Ｐ＜０．０１有微血管病变患者显著高于无微血管病变患者（分别为 １７４．９７±２７．１４ｎｇ／ｍｌ和１５８．１２±２６．１２ｎｇ／ｍｌ　Ｐ＜０．０２）,糖尿病视网膜病变（ＤＲ,ｎ＝４１,１７５．６２±２６．５６ｎｇ／ｍｌ）和糖尿病肾病（ＤＮ, ｎ＝２８, １７９．５９±２９．６６ｎｇ／ｍｌ）患者血清 ＬＮ分别显著高于无 ＤＲ（ｎ＝３５,１６０．７１±２７．１２ｎｇ／ｍｌ）和无ＤＮ（ｎ＝４８,１６０．５３±２４．１１ｎｇ／ｍｌ）的患者（Ｐ＜０．０５,Ｐ＜０．０１）。同时伴有ＤＲ和ＤＮ患者血清ＬＮ高于单有ＤＲ或单有ＤＮ患者。多元逐步回归分析提示糖尿病患者血清ＬＮ浓度增高的程度与其糖尿病病程长短关系密切。糖尿病患者血清ＬＮ与血清ＩＶ型胶原、血清结合珠蛋白水平呈正相关（Ｒ＝０ ５３,Ｐ＜０．００１和Ｒ＝０．４０,Ｐ＜０．０１）

The Level and Relative Factors of Serum Laminin in Diabetic Patients

Objective: To study the relationship between serum laminin (LN) level and the microangiopathy of NIDDM, and search for relative factors of serum LN level in diabetic patients. Methods: The serum LN concentrations in 76 patients with NIDDM and 38 normal controls. Were determined, Results: me serum LN concentration of diabetic patients was higher than that of normal controls (P<0.01). Moreover, the serum LN level of patients with diabetic micro - angiopathy including diabetic retinopathy (DR) and diabetic nephropathy (DN) was increased as compared with patients without microangiopathy (P < 0.02 ). The serum LN levels of patients with DR or DN were higher than those of patients without DR or DN (P < 0.05 and P < 0.01 ) respectively. The serum LN concentration was positively correlated with duration of diabetes, serum collagen IV level and serum haptoglobin level (r=0.33, P<0.01; r=0.53, P<0.001 and r = 0.40, P < 0.01, respectively ). Multiple linear regression analysis showed that duration of diabetes was a factor, which had substantial effects on the serum LN level. Conclusions: The increase of serum LN level was significantly of microangiopathy of NIDDM, and the serum LN level may be a useful serum index of microangiopathy in NIDDM.