论文部分内容阅读
目的通过比较慢性肾脏病(CKD)Ⅲ～Ⅴ期的糖尿病肾病(DN)患者与其他非透析CKD患者的血清可溶性CD146(sCD146)水平,探讨CD146在中晚期DN患者中的表达特点及其临床意义。方法入选CKDⅢ～Ⅴ期的患者共125例,其中DN患者41例(含透析患者18例),高血压肾病31例;慢性肾炎33例;其他肾脏疾病20例;除18例透析的DN患者外,其余均为非透析患者。另设20例健康对照。采用ELISA法检测sCD146水平,免疫散射比浊法检测尿微量白蛋白(MAU)值,分析sCD146在DN患者中的表达特点,探讨sCD146与MAU的关系及其意义。结果正常对照组sCD146浓度为(206.40±29.39)ng/ml,DN非透析组为(433.30±75.46)ng/ml,DN透析组为(492.00±73.62)ng/ml,高血压肾病组为(386.95±82.38)ng/ml,慢性肾炎组为(384.44±73.30)ng/ml,其他肾病组为(368.33±53.42)ng/ml。患病组的血清sCD146水平均显著高于正常组(P<0.05);DN患者外周血sCD146水平明显高于其他CKD患者,其中DN透析患者的sCD146升高尤为显著(P<0.05)。相关性分析表明,DN组患者的血清肌酐、C反应蛋白(CRP),MAU与sCD146呈正相关,估算的肾小球滤过率(eGFR)、血浆白蛋白(ALB)与sCD146呈负相关,多元逐步回归分析结果显示,MAU是影响DN患者sCD146水平的独立因素。结论血清sCD146水平能反映中晚期DN患者血管内皮功能损伤及微炎症状态,与MAU的联合检测在评估DN病情严重程度方面有一定的临床意义。
Objective To compare the serum CD146 (sCD146) levels in diabetic nephropathy (DN) patients with stage Ⅲ ~ Ⅴ chronic kidney disease (CKD) with those in other non-dialysis CKD patients and explore the clinical significance of CD146 expression in patients with advanced stage DN . Methods A total of 125 patients with stage Ⅲ-Ⅴ CKD were enrolled. Among them, 41 patients with DN (18 patients with dialysis), 31 patients with hypertensive nephropathy, 33 patients with chronic nephritis, 20 patients with other renal diseases, and 18 patients with DN , The rest are non-dialysis patients. Another 20 cases of healthy controls. The level of sCD146 was detected by ELISA, the value of urinary microalbumin (MAU) was detected by nephelometry. The expression of sCD146 in DN patients was analyzed, and the relationship between sCD146 and MAU and its significance were analyzed. Results The serum levels of sCD146 in the normal control group were (206.40 ± 29.39) ng / ml, (433.30 ± 75.46) ng / ml in DN non-dialysis group and 492.00 ± 73.62 ng / ml in DN dialysis group ± 82.38 ng / ml, chronic nephritis group was (384.44 ± 73.30) ng / ml, and other nephropathy group was (368.33 ± 53.42) ng / ml. Serum sCD146 levels in patients with DN were significantly higher than those in normal controls (P <0.05). The sCD146 levels in peripheral blood of DN patients were significantly higher than those in other CKD patients, especially in sCD146 patients with DN dialysis (P <0.05). Correlation analysis showed that serum creatinine, C-reactive protein (CRP) and MAU were positively correlated with sCD146 in patients with DN, the estimated glomerular filtration rate (eGFR) and serum albumin (ALB) were negatively correlated with sCD146, Stepwise regression analysis showed that MAU was an independent factor affecting the level of sCD146 in patients with DN. Conclusions Serum sCD146 level can reflect the vascular endothelial dysfunction and microinflammatory state in advanced stage DN patients. The joint detection with MAU has some clinical significance in assessing the severity of DN.