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目的探讨T2DM患者尿液Smad1的表达及其与肾脏损伤的关系。方法选择T2DM患者(T2DM组)118例及正常对照(NC)组28名,按照尿白蛋白/肌酐比值(UACR)分为正常蛋白尿组64例,微量白蛋白尿组36例及大量白蛋白尿组18例。应用ELISA法测定各组尿液Smad1的含量,常规方法测定Cr、胱抑素C(CysC)、FPG、HbA1c、C-P等临床指标,以Macisaac公式估算肾小球滤过率(GFR),分析尿Smad1含量与常用临床指标的相关。结果 T2DM组尿Smad1含量高于NC组,与UACR呈正相关(R=0.412,P=0.000),正常蛋白尿组、微量蛋白尿组、大量蛋白尿组尿Smad1含量呈递增改变;相关分析显示Smad1与FPG、HbA1c呈正相关,与FC-P肽呈负相关;Logistic回归分析表明尿液Smad1是T2DM患者肾功能损伤的独立危险因素。结论尿液Smad1可反映DN损伤程度并与DN分期相关;尿液Smad1的检测对DN患者病情观察、疗效判断具有一定的临床价值。
Objective To investigate the expression of Smad1 in urine of patients with T2DM and its relationship with renal injury. Methods Totally 118 patients with T2DM (T2DM group) and 28 normal controls (NC) were divided into urinary albumin / creatinine ratio (UACR) according to urinary albumin / creatinine ratio (64 cases), microalbuminuria group Urine group of 18 cases. The contents of Smad1 in urine were measured by ELISA. The clinical parameters of Cr, Cystatin C (CysC), FPG, HbA1c and CP were determined by routine methods. GFR was estimated by Macisaac formula, The content of Smad1 is correlated with common clinical indexes. Results The level of urinary Smad1 in T2DM group was significantly higher than that in NC group (P = 0.000). The urinary Smad1 levels in normal proteinuria group, microalbuminuria group, and macroalbuminuria group were increased gradually. Correlation analysis showed that Smad1 Which was positively correlated with FPG and HbA1c and negatively correlated with FC-P peptide. Logistic regression analysis showed that urine Smad1 was an independent risk factor for renal dysfunction in T2DM patients. Conclusion The urinary Smad1 can reflect the degree of DN damage and is related to the DN staging. The detection of urinary Smad1 has some clinical value in judging the severity of DN patients and judging the curative effect.