糖尿病肾病与sICAM-1表达的关系探讨

目的　研究 2型糖尿病肾病患者血清可溶性细胞间粘附分子 -1(sICAM -1)水平的变化。方法　应用酶联免疫吸附法 (ELISA)测定 12 7例 2型糖尿病患者 (2型糖尿病组 )和 2 0例健康对照者 (正常对照组 )血清sICAM -1水平 ,并测定空腹血糖、糖化血红蛋白、血脂、BUN、Cr、Ccr及UAE水平。据尿白蛋白量多少又分为有肾损害组 (微量和大量蛋白尿组 )和无肾损害组 (尿蛋白在正常范围 )。结果　① 2型糖尿病组血清sICAM -1浓度显著高于正常对照组 (P <0 .0 1)。②有肾病组 (微量蛋白尿组及大量蛋白尿组 )其sICAM -1水平又高于无肾病组及正常对照组 ,(P <0 .0 5～ 0 .0 1)。③sICAM -1的水平与甘油三酯呈正相关 (r=0 .44 ,P <0 .0 5 )。结论　血清sICAM -1参与了糖尿病微血管病变的发病过程 ,是糖尿病病情变化尤其是糖尿病肾病的严重程度指标之一。

The relationship between diabetic nephropathy and the expression of sICAM-1

Objective To investigate the changes of levels of serum sICAM-1 in patients with diabetes nephropathy type Ⅱ. Methods An ELISA method was used to detect the levels of serum sICAM-1 in 127 patients with diabetes mellitus Ⅱ (whom were allocated to three groups according to the urine volume: the normal proteinura group, the micro-proteinura group and the massive proteinura group) and in 20 healthy individuals (the control group); moreover, the levels of fasting blood glucose, glycosylation Hb, blood-fat, BUN, Cr, Ccr and UAE were measured. Results ① The concentration of the levels of serum sICAM-1 in all the patients with diabetes mellitus Ⅱ was far great than that in the control group, P<0.01. ② Levels of sICAM-1 in the micro-proteinuria and massive proteinuria groups were higher than those in the normal proteinuria group and the normal control group, P<0.05～0.01. ③ Levels of sICAM-1 was positively correlated to triglyceride (r=0.44, P<0.05). Conclusions Serum sICAM-1 was involved in the development of the micrangium lesions in diabetes mellitus, and was one of the indexes for evaluating the disease condition of diabetes mellitus, especially for assessing the degrees of the severity of diabetic nephropathy.