不同尿白蛋白水平的糖尿病患者单核细胞趋化蛋白-1和尿N-乙酰β-D-氨基葡萄糖苷酶的含量变化及其临床意义

目的观察不同尿白蛋白水平的糖尿病患者单核细胞趋化蛋白1(MCP1)和尿N乙酰βD氨基葡萄糖苷酶(NAG)的含量变化及其临床意义。方法将60例糖尿病患者按尿白蛋白排泄率(UAER)的不同分为正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组3组。分别测定血清和尿MCP1的含量、尿NAG含量以及血肌酐(Scr)、糖化血红蛋白(GHbAlc),进行组间比较,并与对照组比较,同时做尿MCP1与GHbAlc、UAER、NAG的相关分析。结果尿MCP1含量及NAG含量在所有患者中均升高,明显高于对照组,且大量白蛋白尿组升高最明显,其升高程度与尿白蛋白排泄率增高程度一致,即随糖尿病肾病加重而逐渐升高。而血清MCP1水平较低,与对照组比较无显著性差异;尿MCP1与GHbAlc、UAER、NAG呈正相关关系。结论尿中MCP1升高与糖尿病肾病的发生发展有密切关系,尤其与肾小管间质损伤有更密切的关系。

Clinical significance of MCP-1 ,NAG in patients with diabetic nephropathy

Objective To evaluate the clinical value of monocyte chemoattractant protein-1 (MCP-1) and N-acety1-beta-D-glucosaminidase (NAG) in diabetic nephropathy (DN).Methods Sixty cases with diabetes mellitus were divided into three groups:normal albuminuria,microalbuminuria and macroalbuminuria.The levels of MCP-1,NAG,Scr and GHbAlc were measured.The relationships between MCP-1and UAER,GHbA1c and NAG were analyzed.Results The levels of urinary MCP-1,NAG in all patients were obviously higher than those in healthy controls(P<0.05),the levels of urinary MCP-1,NAG in macroalbuminuria group were the highest.Moreover,the urinary MCP-1 in patients with diabetic nephropathy increased gradually in accordance with the clinical stage of the disease.But the level of serum MCP-1 in all patients was not obviously different from the healthy controls.The levels of urinary MCP-1 were positively correlated with NAG,GHbA1c,and UAER in diabetes mellitus (DM).Conclusion The high level of urinary MCP-1 is associated with the development and progression of DN.Increased urinary expression of MCP-1 in the renal tubuli accelerates tubulointerstitial damage.