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目的:了解糖尿病(DM)患者尿中Ⅳ型胶原(Ⅳ-C)的变化,探讨其与糖尿病肾病(DN)的关系及在DN中的诊断价值。方法:采用放射免疫分析法(RIA)测定103例DM患者尿中Ⅳ—C水平,并以33例健康者作为对照组。结果:DM患者尿中Ⅳ-C水平[(27.71±13.31)μg/L]显著高于对照组[(9.01±3.43)μg/L],(P<0.001),且随肾病加重和病程延长而升高,血糖控制差组较控制良好组水平明显升高。在根据24小时尿白蛋白排泄率(UAER)属于正常白蛋白尿组的DM患者中,尿Ⅳ—C阳性率为44％。尿Ⅳ—C水平不受性别、年龄及血压的影响,和反映肾小球及肾小管功能的指标均显著相关。结论:2型DM存在Ⅳ—C代谢异常,尿Ⅳ—C测定是一个比UAER更好的预测和监测DN发生和发展的指标。
OBJECTIVE: To investigate the changes of urinary type Ⅳ collagen (Ⅳ-C) in patients with diabetes mellitus (DM) and to explore its relationship with diabetic nephropathy (DN) and its diagnostic value in DN. Methods: The urinary Ⅳ-C levels were measured in 103 DM patients by radioimmunoassay (RIA), and 33 healthy controls were used as control group. Results: The urinary levels of Ⅳ-C were significantly higher in diabetic patients (27.71 ± 13.31 μg / L vs 9.01 ± 3.43 μg / L, P <0.001) Elevated, poor blood glucose control group than the control group was significantly higher levels. The urinary IV-C positive rate was 44% in DM patients who belonged to the normal albuminuria group according to the 24-hour urinary albumin excretion rate (UAER). Urine Ⅳ-C levels are not affected by gender, age and blood pressure, and glomerular and tubular function reflect the indicators were significantly correlated. CONCLUSION: Type 2 DM has abnormal IV-C metabolism. Urine IV-C is a better predictor of DN occurrence and development than UAER.