【摘要】 目的本研究通过随访方式探讨早期糖尿病肾病的发生发展与尿KIM-1、NGAL的相关性,为临床诊断及治疗提供参考。方法选取T2DM患者148例,根据尿白蛋白/肌酐比值(ACR)患者分为正常白蛋白尿组(NUA组,n=49)、微量白蛋白尿组(MUA组,n=53)和临床白蛋白尿组(CUA组,n=46),另选健康体检者60例为健康对照组。分析各组研究对象血糖、血脂、肾功能及KIM-1、NGAL水平,用Pearson法分析KIM-1、NGAL与尿ACR的相关性。糖尿病患者随访2年后再次测定尿ACR、KIM-1、NGAL。结果与对照组相比,糖尿病患者总胆固醇、甘油三酯、BUN、血肌酐水平无明显差异,而空腹血糖、HbA1c、NGAL和KIM-1水平明显升高(P<0.05),且随着尿蛋白的升高,水平逐步升高(P<0.05)。与随访前基线比较,NUA组和MUA组患者随访后尿ACR、NGAL、KIM-1明显下降(P<0.05),而CUA组随访前后,差异无统计学意义(P>0.05)。相关性分析提示无论随访前后尿NGAL和KIM-1水平均与尿ACR均明显相关。结论糖尿病早期肾病的发生发展与尿KIM-1、NGAL密切相关。更多还原

【Abstract】 Objective To investigate the relationship between the occurrence and development of early diabetic nephropathy and urinary KIM-1 and NGAL by follow-up, and to provide reference for clinical diagnosis and treatment.Methods A total of 148 patients with T2 DM were enrolled. According to the urinary albumin/creatinine ratio(ACR),the patients were divided into normal albuminuria group(NUA group, n=49), microalbuminuria group(MUA group, n=53), clinical proteinuria group(CUA group, n=46) and selected the health physical examation human as the healthy control group(n=60). Blood glucose, blood lipids, renal function and KIM-1, NGAL levels in each group were analyzed.Pearson method was used to analyze the correlation between KIM-1, NGAL and urinary ACR. Diabetes patients were again tested for urinary ACR, KIM-1, and NGAL after 2 years of follow-up. Results There were no significant differences in total cholesterol, triglyceride, BUN and serum creatinine levels between diabetic patients and the control group, while the fasting blood glucose, HbA1 c, NGAL and KIM-1 levels were significantly higher than those in the control group(P<0.05), and with the urine protein increased, the level gradually increased(P<0.05). Compared with baseline before follow-up, urinary ACR, NGAL, and KIM-1 were significantly decreased in the NUA group and the MUA group(P<0.05). But there was no statistical significance in the CUA group before and after follow-up(P>0.05). Correlation analysis indicated that urinary NGAL and KIM-1 levels were significantly correlated with urinary ACR before and after follow-up. Conclusion The occurrence and development of early diabetic nephropathy is closely related to urinary KIM-1 and NGAL.更多还原