【摘要】 目的探讨2型糖尿病肾病患者尿Ⅳ型胶原的变化和临床意义。方法将2型糖尿病患者依尿白蛋白排泄率(UAER)分为3组,正常白蛋白尿组、微量白蛋白尿组、临床糖尿病肾病(DN)组,设健康对照组共4组。测定空用空腹和餐后2h血糖、糖化血红蛋白、UAER、尿’1微球蛋白、尿β2微球蛋白、尿Ⅳ型胶原、血肌酐等。结果健康对照组、正常白蛋白尿组、微量白蛋白尿组、临床DN组尿Ⅳ型胶原递增;尿Ⅳ型胶原与UAER、糖化血红蛋白、尿,1微球蛋白、尿β2微球蛋白、病程、舒张期血压成正相关;多元逐步回归分析示尿Ⅳ型胶原的独立危险因素依次为UAER、病程、舒张期血压;正常白蛋白尿期有33.3%患者尿Ⅳ型胶原水平显著升高。结论尿Ⅳ型胶原可作为DN早期诊断的参考指标之一,在正常白蛋白尿期可能有前瞻性的应用价值。更多还原

【Abstract】 【Objective】To explore the change of urinary type IV collagen excretion rate in patients with diabeticnephropathy and its implication.【Methods】This study included 25 healthy subjects (control group) and 90 patientswith type 2 diabetes mellitus, diabetic patients were divided into three groups according to their urinary albumin ex-cretion rate (UAER): 30 patients with normal UAER (SDM group), 30 patients with microalbuminuria (EDN group)and 30 patients with clinical proteinuria (CDN group). Urinary type IV collagen excretion rate, UAER, fasting andpostprandial 2 h plasma glucose, HbA1c, urinar!y 1 - microglobulin excretion rate, urinary β2- microglobulin excre-tion rate, blood creatinine were measured.【Results】Urinary type IV collagen excretion rate was increase by degreesin the control group subjects, in the SDM group patients, in the EDN group patients, in the CDN group patients. Uri-nary type IV collagen excretion rate was positively correlated with UAER, HbA1c, urinar!y 1 - microglobulin excretionrate, urinary β2- microglobulin excretion rate, duration of diseases and diastolic blood pressure. In a general multi-variate regression, UAER, duration of diseases and diastolic blood pressure were significantly independent determi-nants for urinary type IV collagen excretion rate. Urinary type IV collagen excretion rate of 10 patients (33.3%) inthe SDM group were significantly increased.【Conclusion】Urinary type IV collagen excretion rate may as a specificindicator of early diabetic nephropathy, it may has premonitory implication in diabetic patients with normal UAER.更多还原