炎症损伤和氧化应激损伤对糖尿病肾病患者尿微量白蛋白/肌酐、24h尿微量白蛋白的影响

摘要

Objective: To explore the effect of inflammatory injury and oxidative stress injury on urine microalbumin/creatinine (UACR) and 24 h urine microalbumin (24hUMA) in patients with diabetic nephropathy.Methods: A total of 54 patients with early diabetic nephropathy treated in our hospital between June 2012 and December 2015 were included in early DN group and 60 patients with clinical diabetic nephropathy were included in clinical DN group.A total of 50 healthy subjects who received physical examination in our hospital during the same period were included in healthy control group.Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum inflammatory injury index levels;automatic biochemical analyzer was used to determine serum oxidative stress injury index levels;immunoturbidimetry was used to detect 24 hUMA, and UACR level was calculated.Results: Serum IL-6, IL-18, IL-27 and TNF-α levels of clinical DN group were significantly higher than those of early DN group and healthy control group while IL-10 level was significantly lower than that of early DN group and healthy control group (P<0.05);serum T-AOC, VitC and GSH-Px levels were significantly lower than those of early DN group and healthy control group while LHP and MDA levels were higher than those of early DN group and healthy control group (P<0.05);UACR and 24 hUMA levels were significantly higher than those of early DN group and healthy control group (P<0.05).Spearman correlation analysis showed that UACR and 24hUMA levels in patients with diabetic nephropathy were directly related to the degree of inflammatory injury and oxidative stress injury.Conclusions: The inflammatory injury and oxidative stress injury directly affect the UACR and 24hUMA levels in patients with diabetic nephropathy, and are the important determinants for the occurrence and development of disease.%目的:探讨炎症损伤和氧化应激损伤对糖尿病肾病患者尿微量白蛋白/肌酐(UACR)、24 h尿微量白蛋白(24 hUMA)的影响.方法:纳入2012年6月~2015年12月上海市徐汇区龙华街道社区卫生服务中心收治的早期糖尿病肾病患者54例作为早期DN组、临床期糖尿病肾病患者60例作为临床DN组.另取同期在本院接受体检的健康人群50例作为健康对照组.采用酶联免疫吸附法(ELISA)检测血清炎症损伤指标含量;采用全自动生化分析仪测定血清氧化应激损伤指标含量;采用免疫比浊法检测24 hUMA,计算UACR水平.结果:临床DN组患者的血清IL-6、IL-18、IL-27、TNF-α含量高于早期DN组、健康对照组,IL-10含量低于早期DN组、健康对照组(P<0.05);血清T-AOC、VitC、GSH-Px含量低于早期DN组、健康对照组,LHP、MDA含量高于早期DN组、健康对照组(P<0.05);UACR、24 hUMA水平高于早期DN组、健康对照组(P<0.05).Spearman相关分析发现,糖尿病肾病患者UACR、24 hUMA水平与炎症损伤和氧化应激损伤程度直接相关.结论:炎症损伤和氧化应激损伤程度直接影响糖尿病肾病患者的UACR、24 hUMA水平,是疾病发生发展的重要决定因素.