血浆可溶性P选择素与炎症因子对糖尿病肾病的影响

目的探讨血浆可溶性P-选择素(sP-selectin)及炎症因子对糖尿病肾病的影响。方法 138例糖尿病肾病患者根据尿白蛋白排泄率(UAER)分为正常蛋白尿组(DM组)、早期糖尿病肾病组(DN1组)及临床糖尿病肾病组(DN2组),收集相关临床资料并检测血浆糖化血红蛋白(HbAlc)、空腹C肽(FCP)、三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、C反应蛋白(CRP)、白介素6(IL-6)、UAER及sP-selectin。结果糖尿病病程、CRP、IL-6、UAER及sP-selectin在DM、DN1、DN23组间依次递增,且组间差异具有统计学意义(P<0.05或P<0.01);FCP的水平在DM、DN1、DN23组间依次递减,组间差异有统计学意义(P<0.05或P<0.01);在所有糖尿病患者中sP-se-lectin与糖尿病病程、LDL-C、CRP、IL-6、UAER呈正相关(r=0.17,P<0.05;r=0.23,P<0.05;r=0.39,P<0.05;r=0.31,P<0.05;r=0.56,P<0.05);与FCP呈负相关(r=-0.35,P<0.05)。多元线性回归分析结果显示FCP、IL-6、UAER是sP-selectin的独立影响因素(P<0.05)。结论可溶性P-选择素与CRP、IL-6及LDL-C、FCP等一起参与了糖尿病肾病的发生及发展。

The effects of serum soluble P-selectin and inflammatory factors in patients with diabetic nephropathy

Objective To investigate the effect of serum sP-select and inflammatory factors in patients with diabetic nephropathy（DN）.Methods 138 diabetic nephropathy patients were divided into three groups according to their urinary albumin excretion rate（UAER）：normal albuminuria group（DM）,incipient DN group（DN1） and overt DN group（DN2）.The relationship of clinical data was analyzed.All patients were tested for HbAlc,FCP,TG,TC,HDL-C,LDL-C,CRP,IL-6,UAER and sP-selectin.Results The duration of diabetes and the level of serum CRP,IL-6,UAER,sP-selectin were more and more higher in group DM、DN1 and DN2（P0.05或P0.01）,the level of serum FCP were more and more lower in group DM、DN1 and DN2（P0.05或P0.01）.The level of serum sP-selectin in all patients with diabetic nephropathy showed positive correlation with the duration of diabetes and the level of LDL-C,CRP,IL-6,UAER（r=0.17,P0.05;r=0.23,P0.05;r=0.39,P0.05;r=0.31,P0.05;r=0.56,P0.05）,but showed negative correlation with the level of FCP（r=-0.35,P0.05）.The multivariate linear regression analysis showed that the level of FCP,IL-6 and UAER seemed independent risk factors for sP-selectin（P0.05）.Conclusion P-selectin maybe involved in the pathogenesis of diabetic nephropathy with CRP、IL-6、LDL-C and FCP.