血清长正五聚蛋白、hsCRP和HbA1c水平与2型糖尿病肾病损害程度的分析

摘要

Objective To evaluate the association between the level of serum long pentraxin-3(PTX3) ,hsCRP and HbAlc and type 2 diabetic (T2DM) nephropathy. Methods Selected 107 cases of patients by coronary angiography. According to the classification of UAER,136 cases of patients with type 2 diabetes were divided into 3 groups:patients with normal UAER (n = 63) .patients with microalbuminuria (n=56) and patients with clinical albuminuria (n=27). The level of serum PTX3 was detected by ELISA. The levels of hsCRP and HbAlc were assayed by immune turbidimetry. Results Serum levels of PTX3,hsCRP and HbAlc were significantly higher in T2DM patients than in healthy controls (P<0. 01). Serum levels of PTX3,hs CRP and HbAlc were significantly higher in T2DM patients with microalbuminuria than in T2DM patients without albuminuria (P<0. 05). With the increasing UAER classification of T2DM patients,PTX3,hsCRP and HbAlc levels increased. There were significantly associations between serum levels of PTX3 (r=0. 712, P=0. 012),hsCRP (r=0. 661, P= 0. 023) and HbAlc (r=0. 631, P=0. 031) and the classification of UARE. The association between the level of PTX3 and the classification of UAER was stronger than that of the levels of hsCRP and HbAlc by multiple linear regression analysis. Conclusion These findings suggest that the inflammatory markers,PTX3 and hsCRP as well as the level of HbAlc would be useful biomarkers for monitoring the progression of type 2 diabetic nephropathy.%目的 通过长正五聚蛋白(pentraxin-3,PTX3)、高敏C反应蛋白(hsCRP)和糖化血红蛋白(HbA1c)联合检测对2型糖尿病(T2DM)肾病损害程度诊断价值分析探讨.方法 以2010年7月～2011年10月西安市北方医院住院和门诊的146例2型糖尿病患者为研究对象,根据24 h尿清蛋白排泄率(UAER)水平分为:正常清蛋白尿组(n=56)、微量清蛋白尿组(n=63)和临床清蛋白尿组(n=27)三组；同时以100例健康查体者作为对照组,使用ELISA法检测血清PTX3,透射免疫比浊法检测血清hsCRP和HbA1c水平.结果 正常、微量和临床尿清蛋白三组,其中2型糖尿病患者PTX3,hsCRP和HbA1c水平均明显高于正常组(P＜0.01),且随着UARE分级增加,PTX3,hsCRP和HbA1c水平也显著增高(P＜0.05).相关分析表明血清PTX3与UAER显著正相关(r=0.712,P=0.012)；hsCRP水平与UAER存在正相关(r=0.661,P=0.023)；HbA1c水平与UAER也存在正相关(r=0.631,P=0.031).多元线性回归分析显示PTX3水平与UAER的相关性强于血渍hsCRP和HbA1c.结论 炎症指标PTX3,hsCRP和HbA1c的联合检测有助于2型糖尿病肾病损害程度的监测.