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目的探讨血浆可溶性P-选择素(sP-selectin)及炎症因子对糖尿病肾病的影响。方法 138例糖尿病肾病患者根据尿白蛋白排泄率(UAER)分为正常蛋白尿组(DM组)、早期糖尿病肾病组(DN1组)及临床糖尿病肾病组(DN2组),收集相关临床资料并检测血浆糖化血红蛋白(HbAlc)、空腹C肽(FCP)、三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、C反应蛋白(CRP)、白介素6(IL-6)、UAER及sP-selectin。结果糖尿病病程、CRP、IL-6、UAER及sP-selectin在DM、DN1、DN23组间依次递增,且组间差异具有统计学意义(P<0.05或P<0.01);FCP的水平在DM、DN1、DN23组间依次递减,组间差异有统计学意义(P<0.05或P<0.01);在所有糖尿病患者中sP-se-lectin与糖尿病病程、LDL-C、CRP、IL-6、UAER呈正相关(r=0.17,P<0.05;r=0.23,P<0.05;r=0.39,P<0.05;r=0.31,P<0.05;r=0.56,P<0.05);与FCP呈负相关(r=-0.35,P<0.05)。多元线性回归分析结果显示FCP、IL-6、UAER是sP-selectin的独立影响因素(P<0.05)。结论可溶性P-选择素与CRP、IL-6及LDL-C、FCP等一起参与了糖尿病肾病的发生及发展。
Objective To investigate the effects of plasma soluble P-selectin and inflammatory cytokines on diabetic nephropathy. Methods 138 patients with diabetic nephropathy were divided into normal proteinuria group (DM group), early diabetic nephropathy group (DN1 group) and clinical diabetic nephropathy group (DN2 group) according to urinary albumin excretion rate (UAER) Plasma HbAlc, FCP, TG, TC, HDL-C, LDL-C, C-reactive protein CRP), interleukin 6 (IL-6), UAER and sP-selectin. Results The course of diabetes mellitus, CRP, IL-6, UAER and sP-selectin were increased in the order of DM, DN1 and DN23, and the difference between groups was statistically significant (P <0.05 or P <0.01) DN1, DN23 in descending order, the difference between groups was statistically significant (P <0.05 or P <0.01); in all diabetic patients with sP-se-lectin and diabetes duration, LDL-C, CRP, IL-6, UAER (R = 0.17, P <0.05; r = 0.23, P <0.05; r = 0.39, P <0.05; r = 0.31, P < r = -0.35, P <0.05). Multivariate linear regression analysis showed that FCP, IL-6 and UAER were the independent influencing factors of sP-selectin (P <0.05). Conclusion Soluble P-selectin is involved in the occurrence and development of diabetic nephropathy along with CRP, IL-6, LDL-C and FCP.