尿VEGF、ET检测对2型糖尿病患者早期肾脏微血管损伤的诊断价值

目的探讨尿血管内皮生长因子（VEGF）、内皮素（ET）对2型糖尿病患者早期肾脏微血管损伤的诊断价值。方法按尿微量蛋白排泄率把76例2型糖尿病患者分为无肾病、早期肾病、临床肾病3组。采用放射免疫法（RIA）和酶联免疫吸附试验（EHSA）测定尿VEGF、α1-微球蛋白（α1-MG）、β2-微球蛋白（β2-MG）、免疫球蛋白G（IgG）、ET水平。结果2型糖尿病患者尿VEGF、ET与对照组比较差异有统计学意义（t≥2．29，P〈0．01），且其水平随病情加重而明显升高；与α1-MG、β2-MG、IgG、Alb、糖化血红蛋白（HbAlc）呈正显著相关（r≥0．309）．而与空腹血糖（FBG）无明显相关（r≤0．06）。结论VEGF、ET参与糖尿病微血管病变的发生、发展；尿VEGF、ET是诊断2型糖尿病患者早期肾脏微血管损伤的敏感指标，对糖尿病肾病的早期诊断和肾功能损害程度的判断有一定的临床诊断价值。

Diagnostic Value of Urinary VEGF and ET Levels for Early Kidney Microvasculature Injury in Patients with Type 2 Diabetes

Objective To discuss the diagnostic value of urinary vascular endothelial growth factor （VEGF） and endothelin （ET） levels for early kidney microvasculature injury in patients with type 2 diabetes. Methods According to urinary albumin excretion rate （UAER）, 76 type 2 diabetes were divided into 3 groups： group of diabetes nephrosis; group of clinic diabetes nephrosis; group of no diabetes nephrosis. The levels of VEGF, α1-MG, β-MG, IgG and ET in urine were detected with RIA and ELISA. Results Compared with the control, the level of urinary VEGF and ET in the group of no diabetes nephrosis increased significantly （t ≥ 2.29, P〈0.01 ） and was associated with the severity degree of disease. There were positive correlation significantly between urinary VEGF, ET and α1-MG, β2-MG, IgG, Alb and Plasma HbAlc （r≥0.309）. And there were not obvious relation between those and FBG. Conclusion VEGF and ET were contributed to development of diabetic microangiopathy. Urinary VEGF and ET were sensitive indices of early kidney microvasculature injury in type 2 diabetes. And have the definite value of clinical diagnosis for early diagnosis of diabetic nephropathy and for estimating renal dysfunction degree.