【摘要】 目的 观察2型糖尿病(Diabetes mellitus DM)患者血浆血栓调节蛋白(Thrombomodulin TM)在糖尿病肾病(Diabeticnephropathy DN)各期的水平,探讨其在DN发生、发展中的作用。方法 用酶联免疫吸附法(ELISA)检测81例2型DM患者血浆TM的水平;用放免法测定尿白蛋白(uAlb)、α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)、TH糖蛋白(THP)的排泄率,并与30例正常对照组进行比较。结果 (1)DM组血浆TM水平明显高于正常对照组,在正常白蛋白尿组即出现TM水平增加(P<0.05),随着尿白蛋白排泄率(UAE)的增加,血浆TM水平递增。(2)血浆TM水平与UAE、α1-MG、β2-MG呈正相关,与THP呈负相关。结论 (1)血浆IM水平是早期诊断DN较敏感的指标,并能反映DN的发生和发展。(2)血浆TM与UAE、α1-MG、β2-MG、THP的联合检测有助于早期诊断DN。更多还原

【Abstract】 Objective To study the role of thrombomodulin (TM) levels in the onset and development of diabetic nephropathy (DN). Methods The levels of plasma TM were determined by enzyme-linked immunosorbent assay in 30 normal controls and 81 patients with type 2 diabetes mellitus (DM group) .The DM patients were divided into three groups according to their urinary albumin excretion (UAE): group 1 with normal albuminuria ( n = 36,UAE< 30 mg/24 h) ;group 2 with microalbuminuria ( n = 30,UAE 30 - 300 mg/24 h) ;and group 3 with macroalbuminuria ( n = 15, UAE > 300 mg/24 h) .Excretion of urinary albuminuria, α1 - microglobulin(α1-MG) , β2-microglobulin(β2-MG) and Tamm-Horsfall protein (THP) were determined by radioimmunossay in all subjects. Results (1) The plasma TM levels in DM groups were higher than those in controls; The plasma TM levels elevated even in group 1( P < 0.05) , and increased with increasing UAE. (2)There was a positive correlation between plasma TM and UAE,α1-MG and β2-MG,and a negative correlation between plasma TM and urinary THP. Conclusion The plasma TM is a sensitive marker for early diagnosis of DN and reflects the onset and development of DN. The determination of plasma TM and urinary UAE,α1-MG.β2-MG.THP is useful for early diagnosis of DN.更多还原