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目的:探究肾素-血管紧张素-醛固酮系统(RAAS)与转化生长因子-β1(TGF-β1)对糖尿病肾病(DN)合并高血压患者肾功能损伤的影响,为临床治疗提供依据。方法:选择2014年6月2015年6月期间我院收治的DN患者76例为研究对象,根据是否合并高血压将其分为DN合并高血压组(39例)和单纯DN组(37例),另选择我院健康体检者40例为对照组,检测并比较各组间醛固酮(ALD)、肾素、血管紧张素(ATII)、血肌酐(Scr)、肾小球率过滤估计值(e GFR)、尿素氮(BUN)及尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)水平。结果:DN合并高血压组与单纯DN组患者肾素、ATII、Scr、BUN、TGF-β1及NAG水平显著高于对照组,DN合并高血压组肾素、ATII、Scr、BUN及TGF-β1水平均显著高于单纯DN组,差异均具有统计学意(P<0.05);DN合并高血压组患者e GFR水平显著低于对照组与单纯DN组,且单纯DN组显著低于于对照组,差异均具有统计学意(P<0.05);Wilcoxon秩和检验显示,DN合并高血压组肾素、ATII、Scr、BUN、TGF-β1及NAG水平随DN分级增加而增加,e GFR水平随DN分级的增加而降低,差异均有统计学意义(P<0.05);DN合并高血压组患者肾素、ATII及TGF-β1水平与e GFR水平呈现负相关关系(r=-0.523,-0.601,-0.401;P<0.05),与Scr(r=0.338,0.414,0.141,P<0.05)及NAG(r=0.341,0.413,0.411;P<0.05)呈现正相关关系。结论:DN伴高血压患者机体RAAS及血清TGF-β1水平均显著升高,且患者DN病情越重,其水平越高。
Objective: To investigate the effect of renin-angiotensin-aldosterone system (RAAS) and transforming growth factor-β1 (TGF-β1) on renal dysfunction in patients with diabetic nephropathy (DN) complicated with hypertension and provide basis for clinical treatment. Methods: A total of 76 patients with DN who were admitted to our hospital from June 2014 to June 2015 were enrolled in this study. They were divided into three groups according to whether they were complicated by hypertension: 39 patients with DN and 37 patients with DN alone. , And another 40 healthy subjects in our hospital were chosen as the control group. ALD, ATII, Scr, glomerular filtration rate (e GFR, BUN, and urine N-acetyl-β-D-glucosaminidase (NAG) levels. Results: The levels of renin, ATII, Scr, BUN, TGF-β1 and NAG in DN patients with hypertension group and DN group were significantly higher than those in control group. Renin, ATII, Scr, BUN and TGF- (P <0.05). The level of eGFR in patients with DN complicated with hypertension group was significantly lower than that in control group and DN group, and the level of eGFR in DN group was significantly lower than that in control group (P <0.05). The Wilcoxon rank sum test showed that the levels of renin, ATII, Scr, BUN, TGF-β1 and NAG in DN patients with hypertension increased with the increase of DN, and the levels of eGFR (P <0.05). The levels of renin, ATII and TGF-β1 in DN patients with hypertension were negatively correlated with the level of e GFR (r = -0.523, -0.601 , -0.401; P <0.05), which showed a positive correlation with Scr (r = 0.338,0.414,0.141, P <0.05) and NAG (r = 0.341,0.413,0.411; Conclusion: The levels of RAAS and serum TGF-β1 in DN patients with hypertension are significantly increased, and the patients with DN more serious, the higher the level.