糖尿病肾病不同阶段中西医结合治疗前后微血管炎及免疫相关指标的变化

目的：探讨糖尿病肾病不同阶段微血管炎及免疫相关指标的变化和中西医结合治疗前后的恢复情况。方法以糖尿病肾病尿蛋白排泄率不同进行分组，治疗前后测定微血管炎指标及免疫指标的变化情况。所获数据采用SPSS软件包处理，非正态分布的变量取自然对数正态化后进行分析，采用Pearson相关分析、Logistis逐步回归各相关危险因素对因变量hs-CRP的影响大小，所获数据采用单因素方差分析、t检验。结果随着尿蛋白排泄率的增加hs-CRP、HbAlC、TC、TG、LDL-C、CYSC的水平明显升高、eGFR水平明显降低（P＜0.05，P＜0.01）。蛋白尿患者IgA、IgM、C3、C4含量浓度明显升高（P＜0.01）；IgG降低（P＜0.05）。CD4、CD4/CD8、B细胞、NK细胞有显著下降（P＜0.01）。CD3也有下降，CD8升高。治疗3个月后上述各指标在常规治疗组和中西医结合治疗组中均有不同程度的恢复（P＜0.05或P＜0.01），中西医结合治疗效果更好。结论糖尿病肾病早期测定hs-CRP、HbAlC、TC、TG、LDL-C、CYSC、eGFR和UAER可做为判断病情及预后的指标，通过治疗可延缓糖尿病肾病发生、发展，中西医结合治疗明显优于常规治疗。

At different stages of diabetic nephropathy combined traditional Chinese and western medicine treatment of microvascular inflammatory and immune related indicators before and after the change

Objective To evaluate the different stages of diabetic nephropathy microvascular inflammatory and immune related indicators before and after the change and combine traditional Chinese and western medicine treatment of the recovery. Methods Diabetic nephropathy urinary albumin excretion rate of different grouping, determination of microvascular inflammatory indexes before and after treatment and the change of immune indexes. Data obtained by SPSS software package processing, non-normal variables take the natural logarithm normal distribution after the analysis, Pearson correlation analysis, Logistis stepwise regression by using the related risk factors impact on the dependent variable hs-CRP size, the data obtained using the single factor analysis of variance and t test. Results With the increase of urinary albumin excretion rate hs CRP, HbA1C, TC, TG, LDL-C, CYSC level increased significantly, eGFR level significantly decreased （P 〈 0.05, P 〈 0.01）. Proteinuria in patients with IgA, IgM, content of C3 and C4 concentration increased significantly, P 〈 0.01; IgG decreased（P 〈 0.05）. CD4, CD4/ CD8, B cells, NK cells decreased significantly （P 〈 0.01）. There is a decrease in the CD3 also, CD8 increases. 3 months after treatment the above indicators in the conventional treatment group and combine traditional Chinese and western medicine treatment group all have different degrees of recovery（P 〈 0.05, or P 〈 0.01）, combining Chinese and western medicine treatment effect is better. Conclusion Diabetic nephropathy early determination of hs-CRP, HbA1C, TC, TG, LDL-C, CYSC, eGFR and UAER can serve as an index of judging condition and prognosis, through treatment can delay the occurrence and development of diabetic nephropathy, combine traditional Chinese and western medicine therapy is superior to conventional therapy.