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目的探讨2型糖尿病肾病患者机体血红素氧合酶(HO)/一氧化碳(CO)系统指标的变化。方法研究对象为宁夏医科大学附属医院内分泌科住院的2型糖尿病患者127例及30名体检的健康人群,分为对照组、单纯糖尿病组(无并发症,45例)、早期糖尿病肾病组(DNⅠ,有微量白蛋白尿合并眼底病变,42例)、临床糖尿病肾病组(DNⅡ,大量白蛋白尿可伴水肿、高血压或肾功能不全,40例)。检测各组空腹血糖、尿素氮、肌酐、尿白蛋白、胆红素、血清铁、内源性CO。结果 DNⅠ、DNⅡ组的总胆红素、血清铁、内源性CO较对照组明显降低,DNⅡ组较DNⅠ组明显降低,差异均有统计学意义(P<0.05,P<0.01);总胆红素、内源性CO与BUN、Cr、尿ALb均呈负相关,血清铁与尿Alb呈负相关。结论糖尿病肾病患者HO/CO系统代谢产物降低,与肾功能相关指标呈负相关。HO/CO系统有可能参与了糖尿病肾病的发生发展。
Objective To investigate the change of heme oxygenase (HO) / carbon monoxide (CO) system in patients with type 2 diabetic nephropathy. Methods The subjects were 127 inpatients with type 2 diabetes mellitus and 30 healthy people in hospital for endocrinology in Affiliated Hospital of Ningxia Medical University. Patients were divided into control group, simple diabetic group (no complications, 45 cases), early diabetic nephropathy group , Microalbuminuria combined with fundus lesions, 42 cases), clinical diabetic nephropathy group (DN Ⅱ, a large number of albuminuria with edema, hypertension or renal insufficiency, 40 cases). Fasting blood glucose, urea nitrogen, creatinine, urinary albumin, bilirubin, serum iron and endogenous CO were detected in each group. Results The levels of total bilirubin, serum iron and endogenous CO in DN Ⅰ and DN Ⅱ groups were significantly lower than those in control group. The DN Ⅱ group was significantly lower than that in DN Ⅰ group (P <0.05, P <0.01) Red, endogenous CO and BUN, Cr, urine ALb were negatively correlated, serum iron and urine Alb was negatively correlated. Conclusion The metabolic products of HO / CO system in patients with diabetic nephropathy are decreased and negatively correlated with the indexes of renal function. HO / CO system may be involved in the development of diabetic nephropathy.