2型糖尿病肾病患者细胞黏附分子的表达

目的探讨2型糖尿病肾病（Diabetic nephropathy，DN）患者细胞黏附分子（Cell adhesion molecules CAMs）的表达水平与肾脏微血管病变及尿白蛋白的相关性关系。方法采用酶联免疫法、流式细胞术和放射免疫法分别测定95例2型糖尿病患者（其中65例DN）和35例健康对照者外周血中SICAM-1水平及CD11b、CD62P、CD63阳性表达率和尿微量白蛋白排泄率（Urinary Albttmin Excretion，UAER）。结果糖尿病各组SICAM-1水平和CD11b、CD62P、CD63的阳性表达率均明显高于对照组（P〈0．05及0．01）；微量蛋白尿组和临床蛋白尿组的SICAM-1水平和CD11b、CD62P、CD63阳性表达率与未并发肾病组（正常蛋白尿组）比较，均随着病情的加重而增加，差异均有显著性（P〈0．05及0．01）；相关分析SICAM-1水平和CD11b、CD62P、CD63的阳性表达率均与UAER呈正相关（r分别为0．576，0．489，0．445，0．463，P〈0．05）。结论2型糖尿病患者CAMs的高表达与肾脏微血管病变密切相关．并能反映DN严重程度，联合UAER检测对诊断、观察病情及预防肾脏微血管病变的发生发展均有意义。

Expression of cell adhesion molecules in type 2 diabetes patients with nephrotic microangiopathy

Objective To explore the correlation of expression of cell adhesion molecules （SICAM - 1, CD11 b, CD62P, CD63） in Type 2 diabetes patients with nephrotic microangiopathy and urine albuminuria. Methods The expression of CDllb, CD62P and CD63 were determined by flow cytometry （FCW）, SICAM - 1 was determined by ELISA, Urine albuminuria was determined by RIA, 95 patients （ including 65 patients with nephrotic microangiopathy）, and 35 healthy people were determined. Results The levels of expression of cell adhesion molecules in all type 2 diabetes patients were significantly higher than that in healthy controls （P 〈 0.05 - 0.01 ） ; the expression of cell adhesion molecules in microalbuminuria and clinical albuminuria patients were significantly higher than that in normal albuminuria patients without nephrotic microangiopa- thy （ P 〈 0.05 - 0.01 ）, the expression of the four molecular markers was increased along with the progress of the disease . the expression of SICAM- 1, CDllb, CD62P and CD63 were all correlated with urine alumin excretion （UAER） （P 〈 0.05）. Conclusion The enhanced expression of CAMs in type 2 diabetes patients aree closely associated with the nephrotic microangiopathy and correlated with severrity degree of DN,combined UAER to detect was useful for diagnosis and monitoring the clinical course of DN, avoiding nephrotic microangiopathy.