论文部分内容阅读
目的探讨糖尿病肾病(DN)患者血清脂联素(ADPN)与尿微量白蛋白(UMA)的变化及二者联合检测在DN诊断中的价值。方法选取DN患者100例,以评估的肾小球滤过率eGFR≥60、60~15、≤15 ml/[min·(1.73 m2)]将患者分为早期、中期、晚期三组,采用酶联免疫吸附法(ELISA)检测受检者可溶性血管细胞黏附分子1(sVCAM-1)及血清脂联素。同时收集患者临床资料和生化指标、24 h尿中尿微量白蛋白(UMA)、心脏超声检查测量心脏腔径及左心室质量指数(LVMI)。结果早期、中期、晚期三组中高密度脂蛋白胆固醇(HDL-C)、血红蛋白(Hb)、白蛋白(Alb)水平随eGFR降低而下降,ADPN、sVCAM-1、LVMI、UMA、血肌酐(Scr)水平随着eGFR降低而逐渐升高,三组间差异有统计学意义(P<0.05);ADPN与Scr、sVCAM-1、LVMI、UMA呈正相关,与Hb、Alb、HDL-C呈负相关;UMA与糖尿病病程、Scr、ADPN、sVCAM-1、LVMI呈正相关,与HDLC、Alb呈负相关。结论脂联素及尿微量白蛋白可能参与DN的发生、发展,二者联合检测对于诊断早期DN有意义。
Objective To investigate the changes of serum adiponectin (ADPN) and urinary microalbumin (UMA) in patients with diabetic nephropathy (DN) and the value of their combined detection in the diagnosis of DN. Methods 100 patients with DN were enrolled. Patients were divided into three groups: early, middle and late, with glomerular filtration rate eGFR≥60, 60 ~ 15, ≤15 ml / [min · (1.73 m2) The levels of soluble vascular cell adhesion molecule 1 (sVCAM-1) and serum adiponectin were detected by ELISA. At the same time, the clinical data and biochemical indexes of patients were collected. 24 h urinary microalbuminuria (UMA) and cardiac cavity diameter and left ventricular mass index (LVMI) were measured by echocardiography. Results The levels of high density lipoprotein cholesterol (HDL-C), hemoglobin (Hb) and albumin (Alb) in the early, middle and late three groups decreased with the decrease of eGFR. The levels of ADPN, sVCAM-1, LVMI, UMA, (P <0.05). ADPN was positively correlated with Scr, sVCAM-1, LVMI and UMA, but negatively correlated with Hb, Alb and HDL-C ; UMA and diabetes duration, Scr, ADPN, sVCAM-1, LVMI was positively correlated with HDLC, Alb was negatively correlated. Conclusion Adiponectin and urinary microalbumin may be involved in the occurrence and development of DN, and the combined detection of them is of significance in the diagnosis of early DN.