2型糖尿病人尿白蛋白排泄率与尿IgG4的相关研究

目的 测定18例正常人和70例2型糖尿病病人24小时尿UAER(mg/24h)和尿IgG4(μg/24h),计算IgG4/AER指数.方法 70例2型糖尿病病人分为3组：正常尿蛋白组25例(NDN组,UAER<30mg/24h)、微量白蛋白组27例(EDN组,UAER30～300mg/24h)和临床期肾病组18例(CDN组,UAER>300mg/24h).结果 尿IgG4水平CDN组(338.4±228.5ug/24h)、EDN组(96.0±81.7ug/24h)均明显高于NDN组(9.9±6.3ug/24h)和正常对照组(9.8±4.4ug/24h),差异有非常显著性(p<0.01).IgG4/AER指数在CDN组明显降低(0.31±0.28),与EDN组(0.87±0.63)、NDN组(0.68±0.40)和正常对照组(0.66±0.33)分别比较,差异有显著性(p<0.05).3组糖尿病人分别进行UAER与IgG4直线相关分析,结果NDN组(r=0.6153),EDN组(r=0.7550),呈非常显著正相关(p<0.001),CDN组(r=0.1615)两者之间无显著相关(p>0.05).结论 尿IgG4水平在早期糖尿病肾病已显著升高,与UAER显著正相关,IgG4/AER指数下降可能预示肾病变发展.

Associated Study on UAER and Urinary IgG4 in Type 2 Diabetic Patients

Objective The UAER (urinary albumin ejection rate,mg/24h) andlevels of urinary IgG4(μg/24h)were detected,IgG4/AER index was counted in 70 Type 2 diabetics and 18 healthy individuals.Methods 70 patients were devided into three groups.The UAER was lower than 30mg/24h in group NDN (25 patients),30-300mg /24h in group EDN (27 patients) and higher than 300mg/24h in group CDN(18 patients).Results The levels of urinary IgG4 was higher significantly in group CDN (338.4+228.5ug/24h) and in group EDN(96.0+81.7ug/24h)compared to group NDN (9.9+6.3ug/24h) and healthy subjects (9.8+4.4ug/24h),p<0.01.IgG4/AER index was lower significantly in group CDN(0.31+0.28) compared separately to group EDN(0.87+0.63),group NDN(0.68+0.40) and healthy subjects (0.66+0.33),p<0.05.The association between the UAER and urinary IgG4 values was studied separately in three group patients by linear relation analysis.The both were correlated significantly in group NDN(r=0.6153,p<0.001) and group EDN(r=0.7550,p<0.001),and not correlated in group CDN(r=0.1615,p>0.05).Conclutions levels of urinary IgG4 was increased significantly in early stage of diabetic nephropathy and correlated with UAER,and IgG4/AER index decreased that might be the development of diabetic nephropathy.