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目的:探讨糖尿病肾病(DKD)患者血清视黄醇结合蛋白(RBP)、基质细胞衍生因子-1(SDF-1)与肾功能的关系。方法:前瞻性选取2017年10月—2020年10月滨州医学院烟台附属医院收治的2型糖尿病(T2DM)患者438例，根据有无合并DKD分为单纯T2DM组(n n＝276)和DKD组(n n＝162)，根据尿白蛋白/肌酐比值(UACR)分为正常(n n＝25)、微量(n n＝75)以及大量白蛋白尿组(n n＝62)，根据估算肾小球滤过率(eGFR)分为G1期(n n＝28)、G2期(n n＝27)、G3a +G3b期(n n＝35)、G4期(n n＝39)以及G5期(n n＝33)，分析RBP、SDF-1与肾功能指标UACR、血尿酸(UA)、血清尿素氮(BUN)、βn 2-微球蛋白(βn 2-MG)、血肌酐(Scr)的关系。正态分布的计量资料以均数±标准差(n Mean±n SD)表示，两组间比较采用独立样本n t检验，多组间比较采用单因素方差分析；计数资料组间比较采用n χ2检验。受试者操作特征曲线(ROC)用于分析RBP、SDF-1对DKD的判别价值；Pearson用于指标间的相关性分析；多元线性回归分析用于RBP的影响因素分析。n 结果:DKD组患者的糖尿病病程长，RBP、UACR、UA、BUN、βn 2-MG、Scr水平高，SDF-1、eGFR低，与单纯T2DM组相比，差异具有统计学意义(n P<0.05)。RBP、SDF-1判别DKD的曲线下面积为0.903、0.868，最佳截断值为70.71 mg/L、5.69 ng/mL。随着尿白蛋白和临床分期的增加，RBP、UACR、UA、BUN、βn 2-MG、Scr水平逐渐升高，SDF-1、eGFR逐渐降低，差异均具有统计学意义(n P<0.05)。DKD患者RBP与UACR、UA、BUN、βn 2-MG、Scr均具有显著正相关关系(n r＝0.764、0.787、0.693、0.577、0.801，n P<0.000 1)，与eGFR具有显著负相关关系(n r＝-0.782，n P<0.000 1)。SDF-1与UACR、UA、BUN、βn 2-MG、Scr均具有显著负相关关系(n r＝-0.744、-0.794、-0.666、-0.605、-0.820，n P<0.000 1)，与eGFR具有显著正相关关系(n r＝0.767，n P<0.000 1)。多元线性回归方程为：RBP＝29.852+0.007UACR+0.101UA+0.497BUN+0.034Scr-0.083eGFR(n P<0.001)。n 结论:RBP和SDF-1对T2DM人群中的DKD患者具有一定的判别价值，且DKD肾功能损伤程度与RBP呈正相关，与SDF-1呈负相关，UACR、UA、BUN、Scr升高以及eGFR下降是RBP升高的危险因素。“,”Objective:To investigate the relationship between serum retinol binding protein (RBP), stromal cell derived factor-1 (SDF-1) and renal function in patients with diabetic nephropathy (DKD).Methods:The patients with type 2 diabetes mellitus (T2DM) admitted to Yantai Affiliated Hospital of Binzhou Medical College from October 2017 to October 2020 were prospectively selected, 438 patients were divided into simple T2DM group (n n=276)and DKD group(n n=162) according to the presence or absence of DKD, according to the ratio of urinary albinin/creatinine (UACR) were divided into normal(n n=25), microalbuminuria (n n=75) and macroalbuminuria group (n n=62), according to the estimated glomerular filtration rate (eGFR) were divided into G1 stage (n n=28), G2 stage (n n=27), G3A + G3B stage (n n=35), G4 stage (n n=39)and G5 stages(n n=33). The relationship between RBP, SDF-1 and renal function index UACR, serum uric acid (UA), blood urea nitrogen (BUN), β n 2-microglobulin (βn 2-MG) and serum creatinine (Scr) was analyzed. Measurement data of normal distribution were expressed as Mean± standard deviation (n Mean±n SD). Independent sample n t-test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups.Chi-square test was used to compare the enumeration data between groups. Receiver operating characteristic curve (ROC) was used to analyze the discriminant value of RBP and SDF-1 for DKD. Pearson was used for correlation analysis among indicators. Multivariate linear regression analysis was used to analyze the influencing factors of RBP.n Results:In the DKD group, the duration of diabetes was longer, the levels of RBP, UACR, UA, BUN, β n 2-MG, Scr were high, SDF-1 and eGFR were lower, with statistically significant differences compared with the simple T2DM group(n P<0.05).The areas under the curve of RBP and SDF-1 to distinguish DKD were 0.903 and 0.868, and the optimal cut-off values was 70.71 mg/L and 5.69 ng/mL. With the increase of urinary albumin and clinical stage, the levels of RBP, UACR, UA, BUN, βn 2-MG, Scr increased gradually, while SDF-1 and eGFR decreased gradually, and the differences were statistically significant (n P<0.05).RBP was positively correlated with UACR, UA, BUN, βn 2-MG and Scr in DKD patients (n r=0.764, 0.787, 0.693, 0.577, 0.801, n P<0.000 1), and negatively correlated with EGFR (n r=-0.782, n P<0.000 1). SDF-1 was negatively correlated with UACR, UA, BUN, βn 2-MG and Scr (n r=-0.744, -0.794, -0.666, -0.605, -0.820, n P<0.000 1), and positively correlated with EGFR (n r=0.767, n P<0.000 1). The multiple linear regression equation was RBP=29.852+ 0.007UACR+ 0.101UA+ 0.497BUN+ 0.034Scr-0.083eGFR (n P<0.001).n Conclusion:RBP and SDF-1 have certain discriminant value for DKD patients in T2DM population, and the degree of DKD renal function injury is positively correlated with RBP and negatively correlated with SDF-1, the increase of UACR, UA, BUN, Scr and the decrease of eGFR are risk factors for the increase of RBP.