糖尿病肾病患者血清脑利钠肽,同型半胱氨酸水平的变化及其意义

摘要

[Objective]To explore the relationship between serum levels of brain natriuretic peptide(BNP), homocysteine(Hcy) and the degree of diabetic nephropathy(DN), and to analyze the changes of BNP and Hcy after intensive glucose control.[Methods]Totally 88 DN patients were randomly chosen.According to 24h urinary albumin(Umalb) and serum creatine(Cr), all patients were divided into normal proteinuria group(SDN group, umalb＜30mg, n = 28) , early DN group(EDN group, 30mg＜umalb＜300mg, n = 24) , clinical DN group(CDN group, umalb≥300mg, n = 22) and chronic renal failure group(CRF group, unalb＞300ng,Cr＞ll0μmol/L, n = 14).Other 28 healthy adults were selected as the control group(NC group).Double antibody sandwich immunofluorescence was used to detect BNP and HT-Ⅱ enzyme linked assay was used to measure the Hcy level.[Results]The BNP level in EDN group, CDN group and CRF group was obviously higher than that in SDN group and NC group( P ＜0.05).The level of BNP was positively correlated with umalb(r = 0.42, P ＜0.05) and Cr(r = 0.56, P ＜0.05).The Hcy level in EDN group, CDN group and CRF group was obviously higher than that in SDN group and NC group( P ＜0.05).The level of BNP was positively correlated with umalb(r = 0.28, P ＜0.05) and Cr(r = 0.46, P ＜0.05).The levels of BNP and Hcy after intensive glucose control were significantly lower than those before treatment( P ＜0.05).[Conclusion]The levels of BNP and Hcy significantly increase in DN patients.Serum levels of BNP and Hcy have good value for predicting the occurrence, development and course of DN.%[目的]探讨糖尿病(DN)肾病血清脑利钠肽(BNP),同型半胱氨酸(Hcy)水平与DN病变程度的关系及强化血糖治疗后二者的变化.[方法]随机选择DN 88例,按24小时尿微量白蛋白(Umalb)及血清肌酐分为正常蛋白尿组(SDM组,Umalb<30 mg,28例),早期肾病组(EDM组,30 mg300 mg,Cr>110 μmol/L,14例).另选健康成人28例作为对照组(NC组),应用双抗夹心免疫荧光法检测BNP,用HT-Ⅱ型酶联法检测Hcy水平并进行比较.[结果]EDM组,CDM组,CRF组BNP明显高于SDM组及NC组(P<0.05),且与Umalb(r=0.42,P<0.05),Cr(r=0.56,P<0.05)呈明显正相关.EDM组,CDM组,CRF组Hcy明显高于SDM组及NC组(P<0.05),且与Umalb(r=0.28,P<0.05),Cr(r=0.46,P<0.05)呈明显正相关.强化血糖控制后BNP,Hcy明显低于治疗前(P<0.05).[结论]DN患者BNP和Hcy水平显著升高,血清BNP和Hcy水平对预测DN的发生发展,病程有较好的价值.