糖尿病肾病患者血清IL-6,sIL-6R水平的变化及意义

目的：探讨糖尿病肾病（DN）患者血清白细胞介素-6（IL-6）及可溶性白细胞介素-6受体（sIL-6R）水平与一系列临床指标的关系。方法：将糖尿病患者根据尿白蛋白排泄率（UAER）分为3组,A组正常白蛋白尿患者UAER〈20μg/min;B组微量白蛋白尿患者UAER20～200μg/min;C组大量白蛋白尿患者UAER〉200μg/min。采用ELISA法检测其与健康对照组血清IL-6、sIL-6R水平分析血清IL-6、sIL-6R与空腹血糖（FBG）、餐后2h血糖（PBG）、糖化血红蛋白（HbAlC）、血尿素氮（BUN）、血肌酐（Cr）、血脂、血压、体重指数（BMI）、腰臀比值（W/S）、UAER的关系。结果：（1）糖尿病患者血清中IL-6水平明显增高,与对照组相比差异有统计学意义（P〈0.01）;B、C组与A组比较亦明显增高（P〈0.05）,且C组增高较B组更明显（P〈0.01）;（2）糖尿病患者血清sIL-6R水平明显增高,与对照组相比差异有统计学意义（P〈0.01）;C组较A、B两组增高均明显,但B组较A组患者差异比较无统计学意义;（3）糖尿病合并高血压患者血清中IL-6、sIL-6R水平均较DM无高血压患者增高（P〉0.05）。结论：IL-6的测定有助于糖尿病肾病的早期诊断和病情检测。

Serum IL-6 and sIL-6R levels and their significance in patients with diabetic nephropathy

Objective：To investigate the relationship of serum interleukin-6（IL-6） and soluble interleukin-6 receptor（sIL6R） levels to a series of clinical data in patients with diabetic nephropathy （DN）.Methods：Subjects were divided into three main groups,based on urinary albumin excretion rate（UAER）：（1）those with normal albuminuria（UAER20 μg/min） in group A,（2）those with microalbuminuria （UAER：20～200 μg/min） in group B and （3） those with macroalbuminuria （UAER200 μg/min） in group C.The serum levels of IL-6 and sIL-6R were measured by ELISA method and their relationship with main clinical features such as FBG,PBG,HbAlC,serum lipid,renal function,UAER,BP and BMI was analyzed.Results：（1）Serum IL-6 levels in patients with diabetes were significantly higher,compared with those in the control group,and there were significant differences（all P0.01）.Compared with group A,they increased significantly in both group B and group C,（all P0.05）,and in C group they increased more significantly than those in group B（P0.01）.（2） Compared with those in the control group,sIL-6R serum levels in patients with diabetes were significantly higher,and there was significant difference （all P0.01）;among them,the results of C group increased most significantly （all P0.05） and there was no significant difference between group A and B.（3）Serum IL-6 and sIL-6R levels in patients with DM and hypertension were higher than those of DM patients without hypertension,but there was no significant difference （all P0.05）.Conclusion：The determination of IL-6 is helpful to early diagnosing the disease and detecting its condition.