糖尿病肾病不同病期的血清IV型胶原、层粘连蛋白水平变化及其影响因素

目的探讨糖尿病肾病(DN)患者血清IV型胶原(IV-C)、层粘连蛋白(LN)水平变化的特点,并对其临床影响因素进行分析。方法166例2型糖尿病(DM)患者分为正常蛋白尿组(DM1)46例,微量蛋白尿组(DM2)85例,临床蛋白尿组(DM3)35例。设健康体检者55人为对照组。采用放免法测其血清IV-C、LN含量,同时测定血糖、糖化血红蛋白、血脂、血压、体重指数。结果DM患者血清IV-C、LN水平高于对照组(P<0.01);DM患者从正常蛋白尿组、微量蛋白尿组到临床蛋白尿组,血清IV-C、LN水平逐增高,各组间存在显著性差异(P<0.01);血清IV-C、LN与糖化血红蛋白、血压、病程呈正相关。结论血清IV-C、LN与DN的发生发展密切相关,将血清IV-C、LN与尿白蛋白排泄率联合检测,能更全面地反映DN的病变程度。尽早控制血糖血压是延缓DN发展必不可少的措施。

The changes of the serum level of the type IV collagen as well as laminin in diabetic nephropathies and its correlated risk factors

Objective To investigate the changes of the serum level of the type IV collagen(IV-C)as well as laminin(LN)in diabetic nephropathy,and its correlated risk factors were analyzed.Methods 166type2DM patients were divided into three groups:Normal-albumin-urea group(DM1)in46cases,Micro-albumin-urea group(DM2)in85cases,Clinic-albumin-urea group(DM3)in35cases.And55healthy persons were selected as control group.The serum level of IV-C and LN were determined by radio-immunoassay.In the meantime,the level of plasma glucose,HbA1C,blood lipid,blood pressure and BMI were also determined.Results The serum level of IV-C and LN of DM patients were significantly higher than that of control group(P<0.01).The serum level of IV-C and LN of group DM3was the highest,the level of group DM1was the lowest,and the level of group DM2stand between the two groups.The serum level of IV-C and LN were significantly different within the three groups(p<0.01).The serum level of IV-C and LN were positive correlated with HbA1C,blood pressure,and the course of diabetes.Conclusions The serum level of IV-C&LN was closely related with DN.The combination determination of serum level of IV-C,LN and Urinary albumin excretion rate,can fully reflect the damage of kidney.To control blood pressure and plasma glucose ASAP is the essential step to postpone the progress of DN.