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1.
目的:观察实验性糖尿病大鼠尿IV型胶原的变化并探讨其与糖尿病肾病其他检测指标的关系。方法:实验于2002-02/2004-10在大连医科大学中心实验室完成。①分组:取雄性SD大鼠54只,随机分成对照组24只和模型组30只。②动物模型建立:尾静脉一次性注射链尿佐菌素(55mg/kg),测血糖≥16.7mmol/L,尿糖持续阳性大鼠定为糖尿病模型动物。符合标准的为糖尿病组24只,对照组注射等量柠檬酸钠缓冲液。③检测方法及观测指标:两组分别于病程的第2,3,6,9周随机取6只大鼠,经测定尿白蛋白正常而尿IV型胶原增高的糖尿病大鼠为糖尿病肾病待定组(n=5)。随后麻醉状态下处死大鼠,检测血糖、血肌酐、肌酐清除率;用病理图像自动分析仪测定肾小球平均体积、PAS阳性物质含量。结果:对照组大鼠24只,糖尿病模型组大鼠24只,糖尿病肾病待定组大鼠5只全部进入结果分析。①糖尿病组2,3,6,9周,尿IV型胶原、尿白蛋白、肌酐清除率均显著高于对照组(P<0.05~0.001);病程第2周,尿IV型胶原增高109.1%,尿白蛋白仅增高23.7%。②糖尿病肾病待定组肾小球平均体积、肌酐清除率均高于正常参考值[肾小球平均体积(1×103mm3):糖尿病肾病待定组分别为498.88,498.88,470.05,468.26,490.44,正常参考值为(244.1~322.1)×103mm3;肌酐清除率(mL/min·kg):分别为7.36,9.52,11.62,7.57,9.69,正常参考值为(1.73~4.33)mL/min·kg]。③尿IV型胶原与血肌酐、尿白蛋白正相关(r=0.63,0.88,P<0.001),与PAS灰度、肌酐清除率负相关(r=-0.71,-0.45,P<0.001)。结论:尿IV型胶原能更早、更敏感地对糖尿病肾病作诊断,并且还能监测病情的发展变化。  相似文献   

2.
血和尿Ⅳ型胶原对早期糖尿病肾病诊断的意义   总被引:7,自引:0,他引:7  
目的:探讨血和尿Ⅳ型胶原(ⅣC)含量在非胰岛素依赖型糖尿病(NIDDM)中的变化及对肾功能损害早期诊断的价值。方法:采用酶联免疫法和放射免疫法测定33例病史5年以上、血尿素氮(BUN)和肌酐(SCr)均在正常范围内的NIDDM患者(糖尿病组)和30例非糖尿病患者(对照组)血和尿中ⅣC含量及尿微量白蛋白(UA)含量,比较2组患者上述各项指标及检测阳性率。结果:糖尿病患者血和尿中ⅣC阳性率(分别为78.79%和100.00%)及其含量〔血ⅣC(160.20±66.01)μg/L,尿ⅣC(67.35±8.31)μg/L)〕均明显高于对照组〔分别为10.00%、6.67%、(61.78±29.26)μg/L和(2.26±2.36)μg/L〕,P均<0.01。且糖尿病患者尿ⅣC检测阳性率(100.00%)明显高于尿微量白蛋白检测阳性率(18.18%,P<0.01),其含量变化二者呈明显正相关(r=0.8924,P<0.01)。结论:测定糖尿病患者血、尿ⅣC,尤其是尿ⅣC较尿UA测定对DN更具早期诊断价值;ⅣC是早期糖尿病肾损害的预警指标之一。  相似文献   

3.
目的探讨尿Ⅳ型胶原(Ⅳ-C)的检测在糖尿病肾病(DN)中的早期诊断价值。方法65例2型糖尿病(DM)患者根据尿白蛋白排泄率(UAER)分为正常白蛋白尿组(DM1)、微量白蛋白尿组(DM2)和大量白蛋白尿组(DM3),检测各组尿Ⅳ-C及尿微量白蛋白(MA)含量,并与42例正常对照组(NC)进行比较。结果DM患者尿Ⅳ-C含量显著高于NC组(P<0.05),且尿Ⅳ-C在DM 1、2、3组间呈逐组增高趋势,均有显著差异(P<0.01),尿Ⅳ-C与UAER呈显著正相关(P<0.01)。结论尿Ⅳ-C测定可作为DN早期诊断更有用的指标。  相似文献   

4.
目的:观察实验性糖尿病大鼠尿Ⅳ型胶原的变化并探讨其与糖尿病肾病其他检测指标的关系。 方法:实验于2002—02/2004—10在大连医科大学中心实验室完成。①分组:取雄性SD大鼠54只,随机分成对照组24只和模型组30只。②动物模型建立:尾静脉一次性注射链尿佐菌素(55mg/kg),测血糖≥16.7mmol/L,尿糖持续阳性大鼠定为糖尿病模型动物。符合标准的为糖尿病组24只,对照组注射等量柠檬酸钠缓冲液。③检测方法及观测指标:两组分别于病程的第2,3,6,9周随机取6只大鼠,经测定尿白蛋白正常而尿Ⅳ型胶原增高的糖尿病大鼠为糖尿病。肾病待定组(n=5)。随后麻醉状态下处死大鼠,检测血糖、血肌酐、肌酐清除率;用病理图像自动分析仪测定肾小球平均体积、PAS阳性物质含量。 结果:对照组大鼠24只,糖尿病模型组大鼠24只,糖尿病肾病待定组大鼠5只全部进入结果分析。①糖尿病组2,3,6,9周,尿Ⅳ型胶原、尿白蛋白、肌酐清除率均显著高于对照组(P〈0.05~0.001);病程第2周,尿Ⅳ型胶原增高109.1%,尿白蛋白仅增高23.7%。②糖尿病肾病待定组肾小球平均体积、肌酐清除率均高于正常参考值[肾小球平均体积(1&;#215;10^3mm^3):糖尿病肾病待定组分别为498.88,498.88,470.05,468.26,490.44,正常参考值为(244.1~322.1)&;#215;10^3mm^3;肌酐清除率(mL/min&;#183;kg):分别为7.36,9.52,11.62,7.57,9.69,正常参考值为(1.734.33)mL/min&;#183;kg]。③尿Ⅳ型胶原与血肌酐、尿白蛋白正相关(r=-0.63,0.88,P〈0.001),与PAS灰度、肌酐清除率负相关(r=-0.71,-0.45,P〈0.001)。 结论:尿Ⅳ型胶原能更早、更敏感地对糖尿病肾病作诊断,并且还能监测病情的发展变化。  相似文献   

5.
血、尿Ⅳ型胶原测定对糖尿病肾病早期诊断的意义   总被引:2,自引:0,他引:2  
目的 探讨血,尿Ⅳ型胶原在糖尿病肾病(DN)早期诊断中的价值。方法 108例糖尿病患者按照Mogensen法分类分为无糖尿病肾病组(无DN组),早期糖尿病肾病且(早期DN组),临床糖尿病肾病组(临床DN组)3组,另选取38健康人为对照组,各组均采用放射免疫法测定血,尿Ⅳ型胶原含量,并行比较分析。结果 无DN组,早期DN组,临床DN组血,尿Ⅳ型胶原含量与对照组比较均有显著性差异(P〈0.05,P〈0  相似文献   

6.
目的观察实验性糖尿病大鼠尿Ⅳ型胶原的变化并探讨其与糖尿病肾病其他检测指标的关系.方法实验于2002-02/2004-10在大连医科大学中心实验室完成.①分组取雄性SD大鼠54只,随机分成对照组24只和模型组30只.②动物模型建立尾静脉一次性注射链尿佐菌素(55 mg/kg),测血糖≥16.7 mmol/L,尿糖持续阳性大鼠定为糖尿病模型动物.符合标准的为糖尿病组24只,对照组注射等量柠檬酸钠缓冲液.③检测方法及观测指标两组分别于病程的第2,3,6,9周随机取6只大鼠,经测定尿白蛋白正常而尿Ⅳ型胶原增高的糖尿病大鼠为糖尿病肾病待定组(n=5).随后麻醉状态下处死大鼠,检测血糖、血肌酐、肌酐清除率;用病理图像自动分析仪测定肾小球平均体积、PAS阳性物质含量.结果对照组大鼠24只,糖尿病模型组大鼠24只,糖尿病肾病待定组大鼠5只全部进入结果分析.①糖尿病组2,3,6,9周,尿Ⅳ型胶原、尿白蛋白、肌酐清除率均显著高于对照组(P<0.05~0.001);病程第2周,尿Ⅳ型胶原增高109.1%,尿白蛋白仅增高23.7%.②糖尿病肾病待定组肾小球平均体积、肌酐清除率均高于正常参考值[肾小球平均体积(1×103 mm3)糖尿病肾病待定组分别为498.88,498.88,470.05,468.26,490.44,正常参考值为(244.1~322.1)×103 mm3;肌酐清除率(mL/min·kg)分别为7.36,9.52,11.62,7.57,9.69,正常参考值为(1.73~4.33)mL/min·kg].③尿Ⅳ型胶原与血肌酐、尿白蛋白正相关(r=0.63,0.88,P<0.001),与PAS灰度、肌酐清除率负相关(r=-0.71,-0.45,P<0.001).结论尿Ⅳ型胶原能更早、更敏感地对糖尿病肾病作诊断,并且还能监测病情的发展变化.  相似文献   

7.
尿Ⅳ型胶原检测在糖尿病肾病中的诊断价值   总被引:1,自引:0,他引:1  
目的:了解糖尿病(DM)患者尿中Ⅳ型胶原(Ⅳ-C)的变化,探讨其与糖尿病肾病(DN)的关系及在DN中的诊断价值。方法:采用放射免疫分析法(RIA)测定103例DM患者尿中Ⅳ—C水平,并以33例健康者作为对照组。结果:DM患者尿中Ⅳ-C水平[(27.71±13.31)μg/L]显著高于对照组[(9.01±3.43)μg/L],(P<0.001),且随肾病加重和病程延长而升高,血糖控制差组较控制良好组水平明显升高。在根据24小时尿白蛋白排泄率(UAER)属于正常白蛋白尿组的DM患者中,尿Ⅳ—C阳性率为44%。尿Ⅳ—C水平不受性别、年龄及血压的影响,和反映肾小球及肾小管功能的指标均显著相关。结论:2型DM存在Ⅳ—C代谢异常,尿Ⅳ—C测定是一个比UAER更好的预测和监测DN发生和发展的指标。  相似文献   

8.
2型糖尿病肾病患者尿8-羟基脱氧鸟苷水平检测的意义   总被引:1,自引:0,他引:1  
目的探讨酶联免疫吸附法(ELISA)检测尿8-羟基脱氧鸟苷(8-OHdG)水平在糖尿病肾病(DN)中的意义。方法 ELISA法检测80例2型糖尿病(T2DM)患者和30例健康对照者尿8-OHdG水平。结果 DM组非DN、早期DN及临床DN亚组24h尿8-OHdG水平分别为(19.4±10.5)、(36.1±24.2)和(83.5±53.7)ng/mgCr,均高于健康对照组的(12.2±8.3)ng/mgCr,且与尿清蛋白排泄率(UAER)和糖化血红蛋白(HbA1c)呈正相关。结论 ELISA检测DN患者尿8-OHdG具有简便易行的优点;24h尿8-OHdG水平检测对于判断DN患者病情及预后有一定的意义。  相似文献   

9.
目的 探讨检测尿视黄醇结合蛋白 (RBP)在糖尿病肾病 (DN)早期诊断中的临床意义。方法 分别对 4 2例 2型糖尿病患者及 36例健康对照者用酶联免疫法 (ELISA)测定尿RBP ,用放射免疫法测定尿α1 微球蛋白 (α1 M )、β2 微球蛋白 (β2 M)。结果 糖尿病组三种尿微量蛋白排泄量明显高于健康对照组 ,且以尿RBP敏感性最高。结论 尿RBP的检测可敏感反映早期糖尿病患者肾小管损伤。  相似文献   

10.
丹参对糖尿病早期肾病患者血浆内皮素和IV型胶原的影响   总被引:17,自引:1,他引:17  
目的观察丹参对糖尿病早期肾病患者血浆内皮素 ( ET-1 )、IV型胶原 ( CIV)的影响。方法将 6 6例患者随机分为丹参治疗组 ( 3 6例 )和常规治疗组 ( 3 0例 ) ,另选 2 1例健康人作正常对照。常规治疗组给糖尿病饮食 ,正规皮下注射胰岛素 ;而丹参治疗组在上述治疗基础上加用丹参注射液 2 0 ml静滴 ,每日 1次 ,于治疗 4周后测定血糖 ( FBS) ,糖化血红蛋白 ( Hb AIC)、ET-1、CIV和 2 4小时尿白蛋白排泄率 ( UAER)水平。结果糖尿病肾病患者血浆 ET-1、CIV水平明显高于健康对照 ( P<0 .0 1 ) ;随着血糖的控制 ,ET-1、CIV和 2 4小时 U AER水平均不同程度降低 ,丹参治疗组下降更明显 ( P<0 .0 5 )。结论血浆 ET-1、CIV水平的升高可能是促进糖尿病肾病发生发展的重要因素 ,而丹参可抑制 ET-1产生和 CIV的合成 ,对糖尿病肾病的早期防治有一定作用  相似文献   

11.
Type IV collagen is a major component released from the glomerular and tubular basement membranes. To investigate the alteration of renal type IV collagen turnover in early stage diabetic nephropathy, urinary type IV collagen was measured by a highly sensitive one-step sandwich enzyme immunoassay (EIA). Urinary samples were obtained from 94 diabetic patients without overt proteinuria. Among those patients, 61 were normoalbuminuric and 33 patients were in the microalbuminuric group. Levels of urinary type IV collagen were serially examined at the start of this study and again one year later. The levels of urinary type IV collagen in patients in the microalbuminuric group were significantly higher than those in the normoalbuminuric group (P < 0.01). There was a significant correlation between the concentration of urinary albumin and urinary type IV collagen in both groups (P < 0.05). Twenty-eight patients (45.3%) in the normoalbuminuric group who showed an abnormal elevation of urinary type IV collagen in comparison to the reference range of normal healthy adults (normal range; less than 3.5 μg/g · Cr). Seven (25%) out of these 28 normoalbuminuric patients with increased urinary type IV collagen progressed to the microalbuminuric group one year later. The levels of urinary type IV collagen in such patients were significantly increased. In the 21 patients who stayed within the normoalbuminuric group, the urinary type IV collagen levels were significantly decreased one year later. It appears that the levels of urinary type IV collagen might reflect ongoing alteration of the extracellular matrix (ECM) turnover and might define more specifically the early stage diabetic nephropathy than the detection of microalbuminuria. It is concluded that the serial measurement of urinary type IV collagen can be a useful marker for detecting renal injury in diabetes. J. Clin. Lab. Anal. 12:378–382, 1998. © 1998 Wiley-Liss, Inc.  相似文献   

12.
To investigate the changes of renal type IV collagen turnover in diabetic nephropathy, urinary type IV collagen was measured by a highly sensitive one-step sandwich enzyme immunoassay (EIA). Urinary samples were obtained from 698 diabetic patients and 191 healthy adults. Among the patients, 264 had urinary albumin levels of less than 29 mg/g.creatine (Cr) (Stage I: normoalbuminuric stage), 169 had microalbuminuria from 30 to 299 mg/g.Cr (Stage II: microalbuminuric stage), 84 patients had macroalbuminuria of more than 300 mg/g.Cr and serum Cr of less than 1.1 mg/dl (Stage IIIA: macroalbuminuric stage without renal dysfunction), 97 had macroalbuminuria of more than 300 mg/g.Cr and serum Cr of more than 1.2 mg/dl (Stage IIIB: macroalbuminuric stage with renal dysfunction), and 84 had renal failure (Stage IV). The levels of urinary type IV collagen in Stages II, IIIA, IIIB, and IV were significantly higher than those in Stage I (P < 0.0001). The level of urinary type IV collagen in Stage I (5.00 +/- 0.23 microg/g.Cr; mean +/- SE) was also higher than that in normal adults (3.44 +/- 0.11 microg/g.Cr; mean +/- SE). These levels increased gradually due to progression of the clinical stage of diabetic nephropathy. It appears that the levels of urinary type IV collagen can be a useful marker for detecting renal injuries in diabetes according to our Asian multicenter trials.  相似文献   

13.
Urinary concentrations of type IV collagen in patients with diabetic nephropathy were measured by a highly sensitive, one-step sandwich enzyme immunoassay. Samples from 298 patients with non-insulin-dependent diabetes mellitus (NIDDM) and 80 healthy controls were examined. In diabetic patients with macroalbuminuria or renal insufficiency, the concentrations of urinary type IV collagen were significantly higher than those of diabetic patients with normoalbuminuria or healthy controls (P < 0.001). Urinary type IV collagen concentration in diabetic patients with microalbuminuria was significantly higher than that in diabetic patients with normoalbuminuria or that in healthy controls (P < 0.001). In contrast, there were no significant changes in the concentration of serum type IV collagen between microalbuminuric patients and normoalbuminuric patients. The area under the receiver operating characteristic (ROD) curve for the urinary type IV collagen concentration was equivalent to that of urinary albumin. It was concluded that urinary type IV collagen concentration determined using this method might be a useful marker for the early detection of diabetic nephropathy. J. Clin. Lab. Anal. 11:110–116. © 1997 Wiley-Liss, Inc.  相似文献   

14.
目的探讨尿微量清蛋白(mAlb)检测在社区糖尿病患者糖尿病肾病发生早期监控中的价值。方法用散射比浊法检测本社区糖尿病监控网络内患者和健康对照人群的尿mAlb,并对结果进行统计学分析。结果糖尿病患者尿mAlb检测阳性率明显高于健康对照组,差异有统计学意义(P<0.05)。糖尿病患者尿mAlb阳性率与病程有关,与性别无关。结论尿mAlb检测对糖尿病肾病早期诊断有非常重要的临床参考价值,可作为糖尿病肾病的早期诊断指标在社区基层医院中广泛开展。  相似文献   

15.
目的观察前列地尔联合参麦或黄芪对糖尿病肾病(DN)患者的治疗效果。方法将90例DN患者随机分为3组,对照组给予前列地尔注射液,治疗A组给予前列地尔和参麦注射液,治疗B组给予前列地尔和黄芪注射液。2周为1个疗程,共2个疗程。观察3组患者治疗前后临床指标变化,并用酶联免疫吸附测定(ELISA)法检测患者治疗前后血清中白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)和Toll样受体4(TLR4)水平变化。结果 3组患者临床指标均得到明显地改善,其中治疗A及B组患者总有效率分别为90.0%和93.3%,治疗效果显著好于对照组63.3%(均P0.05)。3组患者血清中IL-6、TNF-α和TLR4水平均显著降低,且治疗A和B组患者降低更为明显。结论前列地尔联合参麦或黄芪能有效地治疗DN,且无严重不良反应的发生。  相似文献   

16.
目的 探讨2型糖尿病(T2DM)及其合并肾病(DN)尿脂质运载蛋白-2(LCN2)浓度变化及临床意义.方法 根据尿清蛋白排泄率(UAER)将115例T2DM患者分为单纯糖尿病(SDM)组46例、早期糖尿病肾病(EDN)组40例和临床糖尿病肾病(CDN)组29例;另选30例健康体检者作为健康对照(NC)组.采用酶联免疫吸附试验双抗体夹心法检测尿LCN2.结果 SDM、EDN、CDN组尿LCN2、超敏C-反应蛋白(hs-CRP)较NC组升高(P<0.05),随病情加重,升高更为明显.尿LCN2与hs-CRP高度相关(r=0.86,P<0.01).T2DM患者尿LCN2水平随着尿清蛋白的增加而升高.结论 T2DM患者尿LCN2水平明显升高,可作为DN早期的敏感的诊断指标.  相似文献   

17.
目的:探讨尿微量清蛋白检测对诊断早期糖尿病肾病的临床意义。方法回顾性分析2011年8月至2013年2月化州市中医院收治的50例糖尿病肾病患者(观察组)和50例健康体检者(对照组)的临床资料。结果观察组患者尿微量清蛋白含量和阳性率均明显比对照组高,差异有统计学意义(P<0.05),但观察组男性患者和女性患者阳性率差异无统计学意义( P>0.05);病程大于12年患者的尿微量清蛋白含量和阳性率均明显比病程0~6、>6~12年患者高,差异有统计学意义( P<0.05),且病程0~6、>6~12年患者尿微量清蛋白和阳性率比较,差异均有统计学意义(P<0.05)。结论尿微量清蛋白检测能够为临床早期发现、诊断和治疗糖尿病肾病提供有效依据。  相似文献   

18.
To determine correlations among the levels of urinary MMP-9 and type-IV collagen, hyperglycemia, urinary protein excretion, and renal injuries in patients with type 2 diabetic nephropathy, we measured levels of urinary MMP-9 and protein, blood urea nitrogen (BUN), serum creatinine (s-Cr), fasting plasma glucose (FPG), and glycohemoglobin A1c (HbA1c) in 47 diabetic patients and 14 healthy adults. Urinary type-IV collagen was also measured in 28 diabetic patients and seven healthy adults. Patients with diabetic nephropathy were divided into two groups: 1). patients with normoalbuminuria or microalbuminuria (0-299 mg/g.Cr; n=27), and 2). patients with macroalbuminuria (>300 mg/g.Cr; n=20). The mean level of urinary MMP-9 in group 2 was significantly higher than those in healthy adults (P<0.05), and the levels of urinary MMP-9 in patients with diabetic nephropathy increased in accordance with the clinical stage of the disease. The levels of urinary MMP-9 tended to be correlated with HbA1c in these patients, but the correlation was not statistically significant. The mean level of urinary type-IV collagen in group 2 of patients with diabetic nephropathy was significantly higher than that in group 1 and healthy adults. Levels of urinary type-IV collagen in patients with diabetic nephropathy also increased in accordance with the clinical stage of the disease. The results suggest that measurements of urinary MMP-9, as well as urinary type-IV collagen, may be useful for evaluating the degree of renal injuries in patients with type 2 diabetic nephropathy, especially in the early stage.  相似文献   

19.
Because type IV collagen is synthesized by podocytes and mesangial cells, we investigated the relationship between levels of urinary type IV collagen (uIV) and renal injuries in patients with IgA nephropathy. uIV was measured by a highly sensitive one-step sandwich enzyme immunoassay prior to renal biopsy. Patients with IgA nephropathy were classified into four grades (grade 1 = good prognosis, grade 2 = relatively good prognosis, grade 3 = relatively poor prognosis, and grade 4 = poor prognosis) by the prognostic criteria of the Ministry of Health, Labor, and Welfare of Japan. Levels of uIV in grade 4 were significantly higher than those in grades 1-3. These levels tended to increase gradually due to progression of renal injuries. The grades were further divided into two groups: group I (good or relatively good prognoses) and group II (relatively poor or poor prognoses). Patients with proteinuria of <1.0 g/day were defined as groups Ip and IIp. The levels of uIV in group II were significantly higher than those in group I, and those in group IIp were significantly higher than those in group Ip. It appears that the level of uIV can be a useful marker for detection of renal injuries in IgA nephropathy.  相似文献   

20.
目的探讨测定尿清蛋白/肌酐比值对诊断早期糖尿病肾病的价值。方法选取105例2型糖尿病患者,其中包括45例早期糖尿病肾病患者,分别计算尿清蛋白/肌酐比值、24h尿蛋白定量及尿清蛋白排泄率,并比较它们之间的关系。结果早期糖尿病肾病组尿清蛋白/肌酐比值与24h尿蛋白定量及蛋白排泄率呈显著相关性(r=0.921,P〈0.01;r=0.857,P〈0.05)。结论尿清蛋白/肌酐比值是诊断早期糖尿病肾病的一项敏感且可靠的指标。  相似文献   

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