2型糖尿病肾病NO、NOS测定及其临床意义

目的 通过对一氧化氮(NO)、一氧化氮合酶(NOS)的配套测定，深入探讨其在2型糖尿病肾病发生发展中的重要意义。方法 设糖尿病不伴蛋白尿组(SDM)、糖尿病伴微量蛋白尿组(IDN)、糖尿病伴大量蛋白尿组(ODN)和对照组(CON)四组，配套测定血清NO及NOS，NO采用硝酸还原酶法，NOS采用分光光度法，尿白蛋白测定采用放射免疫法。结果 IDN组NOS显著高于CON及SDM组，ODN组NOS显著高于其它3组。NO在IDN组较其它组高，而在ODN组较其它组低。SDM组及IDN组NO与NOS呈直线正相关；ODN组NO与NOS无直线相关关系；NO与病程及尿白蛋白排泄率均呈直线负相关。结论 (1)2型糖尿病DN早期NO和NOS增加，参与DN的发生发展；(2)DN晚期NO减少，与NOS的变化无关；(3)NO在2型糖尿病肾病中的变化是一个随病程和病情改变的过程。

Determination of NO and NOS in diabetic nephropathy patients with type 2 diabetes mellitus and its clinical significance

Objective To study the important significance of nitric oxide(NO) and nitric oxide synthase(NOS) among the occurrence and development of diabetic nephropathy of type 2 diabetes mellitus. Methods A total of 165 objects were divided into four groups: 43 cases of control group (CON group); 62 cases of diabetes mellitus without proteinuria (SDM group); albumin of urine among 24 hour (UAER)<30mg/24h; 32 cases of diabetes mellitus with microalbuminuria (IDN group); 30mg/24h300mg/24h. NO of the blood serum was measured by the technique of nitrate reductase, NOS of the blood serum was measured by the spectrophotography, and URAE was measured by the technique of radio immunity. Results NOS level of IDN group was significantly higher than that in SDM group and CON group( P <0.01), and NO was significantly increased in IDN group as compared with that of three other groups( P <0.01). And it was found there were lower NO and higher NOS level in ODN group than those in the other three groups( P <0.01). It was found NO has a linear positive correlation with NOS in SDM and IDN group, but no linear correlation between NO and NOS in ODN group. Otherwise, NO has a linear negative correlation with the course and UAER. Conclusion (1) The increase of NO and NOS at earlier period of DN of type 2 diabetes mellitus takes part in the occurrence and development of DN. (2) The decrease of NO at later period of DN is not because the decrease of NOS. (3) The change of NO is a procedure followed with the alteration of the course and state of an illness in DN of type 2 diabetes mellitus.