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目的观察临床2型糖尿病肾病患者的血清单核细胞趋化蛋白-1(MCP-1)浓度变化,探讨其临床意义。方法临床随机选择2型糖尿病(T2DM)患者61例,根据24h尿微量白蛋白定量(24h-UA)分为糖尿病对照组(T2DM对照组,35例)和糖尿病肾病组(DN组,26例),另外以正常健康人30例为正常对照组。所有入选观察对象均测定空腹血糖(FPG)、糖化血红蛋白(HbA1c)、高敏C反应蛋白定量(hs-CRP)、血清MCP-1浓度和24h-UA。结果与正常对照组比较,T2DM对照组和DN组的FPG、HbA1c、hs-CRP与MCP-1均显著升高(P<0.05)。与T2DM对照组比较,DN组的FPG、HbA1c无明显差异,但是血清hs-CRP、MCP-1浓度和24h-UA均明显升高(P<0.05)。DN组患者的MCP-1浓度与hs-CRP定量有明显的正相关性(r=0.305,P<0.05)。结论糖尿病肾病患者存在明显的炎症应激,导致MCP-1显著升高,MCP-1可以作为糖尿病肾病诊断和病情判断的重要实验室参考指标。
Objective To observe the changes of serum monocyte chemoattractant protein-1 (MCP-1) in patients with type 2 diabetic nephropathy and to investigate its clinical significance. Methods Sixty-one patients with type 2 diabetes mellitus (T2DM) were randomly selected and divided into diabetic control group (T2DM control group, 35 cases) and diabetic nephropathy group (DN group, 26 cases) according to 24h urinary albumin quantitation (24h-UA) , Another 30 cases of healthy normal control group. Fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), high sensitive C-reactive protein (hs-CRP), serum MCP-1 concentration and 24h-UA were measured in all the selected subjects. Results Compared with normal control group, the levels of FPG, HbA1c, hs-CRP and MCP-1 in T2DM control group and DN group were significantly increased (P <0.05). The levels of hs-CRP, MCP-1 and 24h-UA in DN group were significantly higher than those in T2DM group (P <0.05). The concentration of MCP-1 in DN group was positively correlated with the quantitative hs-CRP (r = 0.305, P <0.05). Conclusions There is obvious inflammatory stress in patients with diabetic nephropathy, leading to a significant increase of MCP-1. MCP-1 can be used as an important laboratory reference for the diagnosis and judgment of diabetic nephropathy.