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目的通过测定2型糖尿病(DM)患者血清白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平的变化,探讨其在糖尿病肾病(DN)中的发病学意义,了解其对DM预后的影响。方法采用放射免疫法检测85例2型DM患者血清IL-6和TNF-α水平。并根据24h尿白蛋白排泄率(UAER)将DM患者分为单纯DM组(SDM,n=40),隐性糖尿病肾病组(IDN,n=28)和显性糖尿病肾病组(ODN,n=17),并与32例正常人对照。结果(1)SDM,IDN,ODN3组患者及正常对照组血清IL-6水平分别为(99±16),(112±22),(128±24),(90±15)ng/L,TNF-α水平分别为(127±15),(130±16),(148±22),(112±22)ng/L,经方差分析,各组间差异具有非常显著意义(F=19.27,13.35,P均<0.01),其中SDM,IDN,ODN3组均明显高于正常对照组(P<0.05或P<0.01),ODN组又明显高于SDM组和IDN组(P<0.01),IDN组血清IL-6水平亦较SDM组升高(P<0.05)。(2)糖尿病病程与患者血清IL-6,TNF-α水平呈明显正相关(r=0.396,P<0.01和r=0.277,P<0.05),UAER与患者血清IL-6,TNF-α水平变化亦呈正相关关系(r=0.630,0.426,P均<0.01);空腹血糖与患者血清IL-6,TNF-α水平间均未见相关关系。结论IL-6和TNF-α可能参与了糖尿病及其肾病的发生与发展。血清IL-6,TNF-α水平检测可以作为临床观察DN病情及判断DM预后的参考指标。
Objective To investigate the changes of serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in patients with type 2 diabetes mellitus (DM) Understand its impact on DM prognosis. Methods Serum levels of IL-6 and TNF-α in 85 patients with type 2 DM were detected by radioimmunoassay. According to the urinary albumin excretion rate (UAER), DM patients were divided into three groups: DM group (SDM, n = 40), IDN group (n = 28) and ODN group 17), and with 32 normal controls. Results The serum levels of IL-6 in SDM, IDN and ODN3 groups were (99 ± 16), (112 ± 22), (128 ± 24) and (90 ± 15) ng / L, (127 ± 15), (130 ± 16), (148 ± 22) and (112 ± 22) ng / L, respectively.Analysis of variance showed that there was a significant difference between the groups (F = 19.27, 13.35 , P <0.01). SDM, IDN and ODN3 groups were significantly higher than those of normal control group (P <0.05 or P <0.01), ODN group was significantly higher than SDM group and IDN group (P <0.01) Serum IL-6 levels also increased compared with SDM group (P <0.05). (2) The course of diabetes was positively correlated with the level of IL-6 and TNF-α (r = 0.396, P <0.01 and r = 0.277, P < (R = 0.630,0.426, P <0.01). There was no correlation between fasting blood glucose and serum IL-6 and TNF-αlevels. Conclusion IL-6 and TNF-α may be involved in the occurrence and development of diabetes and nephropathy. Serum IL-6, TNF-α levels can be used as clinical observation of DN and prognosis of DM as a reference index.