【摘要】 目的:对2型糖尿病肾病患者尿白蛋白排泄率(UAER)、炎症因子与踝臂指数(ABI)的相关性进行初步探讨。方法:93例糖尿病肾病患者根据UAER分为早期糖尿病肾病组(DN1组,43例)及临床糖尿病肾病组(DN2组,50例),搜集相关临床资料,检测患者HbAlc、TG、TC、HDL-C、LDL-C、UA、CRP、IL-6及UAER,并用多普勒测定ABI。结果:DN2组糖尿病病程较长(t=4.638,P<0.001),高血压发病率、LDL-C、HbAlc、UA、IL-6、UAER、CRP水平较高(χ2/t=4.854、3.317、6.609、2.120和3.576、10.580、2.790,P均<0.05),HDL-C、ABI水平较低(t=3.483和3.588,P均=0.001);ABI与患者年龄、糖尿病病程、IL-6、UAER、HbAlc、LDL-C、UA具有相关性(r=-0.352、-0.334、-0.299和-0.376,-0.523、-0.505、-0.419,P均<0.05)。多元逐步回归分析结果显示HbAlc、IL-6是ABI的影响因素(β=-0.278和-1.518,P均<0.05),而糖尿病病程、IL-6、ABI是UAER的影响因素(β=0.605、0.801和-2.445,P均<0.05)。结论:糖尿病肾病患者微炎症状态进行性加重,微炎症状态可能是其肾病及周围血管病变进展的共同作用机制之一。更多还原

【Abstract】 Aim: To investigate the correlation among ankle brachial index(ABI),urinary albumin excretion rate(UAER) and inflammatory factors in patients with diabetic nephropathy.Methods:A total of 93 diabetic nephropathy patients were divided into incipient DN group(DN1) and overt DN group(DN2) according to their UAER.The clinical data of the patients were collected.All patients were tested for HbAlc,TG,TC,HDL-C,LDL-C,UA,CRP,IL-6 and UAER.At the same time,the systolic pressures of the brachial artery and ankle artery were detected by Doppler,then the ABI of the patients was caculated.Results:Compared with DN1 group,the diabetes duration of the patients in DN2 group were longer(t=4.638,P<0.001),and the incidence of hypertension and the levels of LDL-C,HbAlc,UA,IL-6,UAER and CRP were significantly higher,but the levels of HDL-C,ABI were significantly lower(P<0.05).The ABI in patients showed correlation with the increase of age,the duration of diabetes,the levels of IL-6,UAER,HbAlc,LDL-C,UA(r=-0.352,-0.334,-0.299 and -0.376,-0.523,-0.505,-0.419,P<0.05).The multivariate stepwise regression analysis showed that the level of HbAlc and IL-6 seemed to be independent risk factors for ABI(β were -0.278,-1.518,P<0.05),and the duration of diabetes,the level of IL-6 and ABI seemed to be independent risk factors for UAER (β were 0.605,0.801,and -2.445,P<0.05).Conclusion:The degree of micro-inflammation becomes more serious with the worsening of diabetic nephropathy.Micro-inflammation is one of the common mechanisms which affect diabetic nephropathy and peripheral artery disease.更多还原