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目的研究糖尿病肾病患者蛋白尿与C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)水平的关系。方法选择2008年6月～2012年6月广州医学院附属广州市第一人民医院治疗的糖尿病患者210例为糖尿病组,根据尿白蛋白排泄率(UAER)的测定结果分为无白蛋白尿组64例,微量白蛋白尿组87例和临床白蛋白尿组59例,选取同期健康体检者82例为对照组,比较各组间CRP、TNF-α和IL-6水平变化。结果无白蛋白尿组、微量白蛋白尿组、临床白蛋白尿组的CRP[(4.79±0.96)、(8.34±2.61)、(12.58±4.27)mg/L]、TNF-α[(1.64±0.31)、(1.99±0.59)、(1.99±0.59)ng/L]、IL-6[(24.53±6.93)、(29.62±7.51)、(29.62±7.51)ng/L]水平均高于对照组[(2.37±0.45)mg/L、(1.03±0.42)ng/L、(10.73±3.25)ng/L],差异均有统计学意义(P<0.05或P<0.01)。结论糖尿病肾病患者的CRP、TNF-α和IL-6水平随尿蛋白排泄率的增加而增加,可作为糖尿病肾病早期诊断的依据。
Objective To investigate the relationship between proteinuria and C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in patients with diabetic nephropathy. Methods A total of 210 diabetic patients treated by Guangzhou First People’s Hospital affiliated to Guangzhou Medical College from June 2008 to June 2012 were selected as diabetic group. According to the results of urinary albumin excretion rate (UAER), they were divided into no albuminuria group 64 cases, 87 cases of microalbuminuria group and 59 cases of clinical albuminuria group. 82 healthy subjects were selected as the control group, and the changes of CRP, TNF-α and IL-6 levels were compared between the groups. Results The CRP (4.79 ± 0.96, (8.34 ± 2.61), (12.58 ± 4.27) mg / L], TNF-α [(1.64 ± 0.31), (1.99 ± 0.59) and (1.99 ± 0.59) ng / L], IL-6 [(24.53 ± 6.93), (29.62 ± 7.51) and (29.62 ± 7.51) ng / L] (2.37 ± 0.45) mg / L, (1.03 ± 0.42) ng / L, (10.73 ± 3.25) ng / L] respectively. There was significant difference between the two groups (P <0.05 or P <0.01). Conclusion The levels of CRP, TNF-α and IL-6 in patients with diabetic nephropathy increase with the increase of urinary protein excretion rate, which can be used as the basis of early diagnosis of diabetic nephropathy.