血清视黄醇结合蛋白与2型糖尿病肾病的关系.DOC

血清视黄醇结合蛋白与2型糖尿病肾病的关系 河南大学淮河医院肾内科 475000 陈宝平 杨素霞 时军 陈芳 赵清 王亚强 摘要 目的 检测2型糖尿病肾病患者血清血清视黄醇结合蛋白（retinol-binding protein (RBP)的水平变化，探讨其与糖尿病肾病的关系。方法 免疫比浊法测定单纯糖尿病组、早期糖尿病肾病组、临床糖尿病肾病组各20例和20例正常对照组血清RBP含量, 比较各组血清RBP水平变化；同时检测尿白蛋白排泄率(UAER)、肌酐 (SCr)、尿素氮(BUN)；比较不同UAER患者RBP、SCr、 BUN的水平变化及其相关性。 结果 2型糖尿病患者肾损害愈重，血清RBP水平愈高，RBP水平与SCr和BUN呈正相关(P 0. 05)； 结论 RBP水平变化反应糖尿病肾脏损伤程度，可作为判断糖尿病肾病早期肾损害程度的指标之一。 关键词 糖尿病肾病 ；血清；视黄醇结合蛋白 The relation between the concentration of retinol-binding protein (RBP) and renal impairment in subjects with diabetic nephropathy. Abstract: Objective To research the relation between the concentration of retinol-binding protein (RBP) and renal impairment in subjects with diabetic nephropathy. Methods Serum levels of RBP were measured by a method of immunonephelomytry in 20 type 2 diabeties mellitus with normal albuminuria,20 type 2 diabetic nephropathy with microalbuminuria, 20 type 2 diabetic nephropathy with marcoalbuminuria and 20 health controls. and we also detected the level of serum creatinine(Scr),blood urea nitrogen , compared the correlationof RBP, Scr with Bun.Results The mean RBP level was significantly higher in the type 2 diabetes mellitus with normoalbuminuria than healthy controls ; Higher Serum RBP in type 2 diabetic nephropathy with marcoalbuminuria than in those with microalbuminuria. (p 0.01). Serum RBP levels had a positive correlation with serum creatinine levels(r = 0.412, p0.05), and blood ureae (r = 0.317, p0.05). Conclusions The concentration of RBP increased in patients with diabetic nephropathy ,which.related to the severity of diabetic nephropathy. RBP may reflect both glomerular and proximal tubular dysfunction at early stages of diabetic nephropathy . Key words: diabetic nephropathy; RBP 糖尿病肾病(DN)是糖尿病(DM)常见而严重微血管并发症之一，最终发展为终末期肾衰竭，是糖尿病的主要死亡原因。研究已经证实尿RBP是反映肾小管的损伤的灵敏指标之一1），而其在血液中的水平与2型糖尿病肾病的临床研究甚少。本研究对2型糖尿病肾病患者血清RBP水平进行检测，探讨其与2型糖尿病肾病的关系。 1.资料与方法 1. 1 一般资料 选择2009年6月到2010年6月我院门诊及住院的2型糖尿病患者60例，年龄56~72岁（63..92±6..26岁），其中男28例，女32例，符合199