糖尿病肾脏疾病患者血清三叶因子水平变化的临床意义

目的 探讨糖尿病肾脏疾病（diabetic kidney disease,DKD）患者血清三叶因子（trefoil factor 3,TFF3）水平的变化及其临床意义.方法 依据24 h尿白蛋白排泄率（urine albumin excretion rate,UAER）将123例2型糖尿病（type 2 diabetes mellitus,T2DM）患者分为3组：单纯糖尿病组（SDM组,UAER＜30 mg/24 h）42例;早期糖尿病肾脏疾病组（EDKD组,UAER 30～300 mg/24 h）46例;临床糖尿病肾脏疾病组（CDKD 组,UAER＞300 mg/24 h）35例.另选择健康体检者20名为对照组.用酶联免疫吸附测定（enzyme linked immunosorbent assay,ELISA）检测所有研究对象血清TFF3表达水平,并对相关临床资料进行统计学分析.结果 CDKD组的血清TFF3水平（71.33±9.48）ng/ml]明显高于其他3组,EDKD组患者血清TFF3水平（49.31±8.93）ng/ml]显著高于SDM组（32.65±7.27）ng/ml],而对照组血清TFF3水平最低（17.65±6.27）ng/ml],各组间比较有统计学差异（P＜0.01）.Pearson相关分析显示,T2DM患者血清TFF3水平与UAER呈正相关（r＝0.897,P＜0.05）.结论 血清TFF3表达水平与DKD的发生、发展呈正相关,可作为预测及判断DKD严重程度的重要指标之一.

Clinical significance of changes in serum trefoil factor 3 levels in type 2 diabetic patients with kidney disease

Objective To investigate and evaluate serum levels of Trefoil Factor 3 （TFF3） in type 2 diabetic mellitus （T2DM） patients with kidney disease. Methods A total of 123 T2DM patients were divided into three groups according to the level of urine albumin excretion rate （UAER）： 42 patients in simple DM group （SDM group, UAER 0-30 mg/24 h） ,46 patients in early diabetic kidney disease group （EDKD group, UAER 30-300 mg/24 h）, and 35 patients in clinical diabetic nephropathy group （CDKD group, UAER〉300 mg/24 h）. A total of 20 volunteers with normal glucose tolerance served as the control group. Serum TFF3 levels were measured by enzyme linked immunosorbent assay. Clinical materials were collected simultaneously and analyzed statistically. Results The serum levels of TFF3 were significantly higher in CDKD group （71. 33 ± 9.48） ng/ml] than those in the other three groups. The serum levels of TFF3 were significantly higher in EDKD group （ 49. 31 ± 8. 93） ng/ ml] than those in SDM group （32.65 ± 7. 27）ng/ml], and those in control group （ 17.65 ± 6.27） ng/ ml] were lowest （P〈0.01 for all）. Pearson correlation analysis showed that serum levels of TFF3 were positively correlated with UAER （r = 0. 897, P〈0. 05）. Conclusions Serum TFF3 levels are related with the development of type 2 diabetic kidney disease, and serum TFF3 levels could be used as effective serological indicators to predict the severity of DKD.