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目的研究糖尿病慢性肾脏疾病(CKD)不同阶段患者血清多聚ADP核糖聚合酶(PARP)水平的变化及临床意义。方法收集T2DM患者195例,根据尿白蛋白/肌酐(UACR)水平,分为UACR<30 mg/g组、UACR 30~300 mg/g组、UACR>300 mg/g组,另选健康志愿者68名作为正常对照(NC)组。收集标本检测PARP、纤维蛋白原(Fg)、3硝基酪氨酸(3-NT)、单核细胞趋化蛋白-1(MCP-1)、TGF-β1水平,并行相关性分析及多元逐步回归分析。结果 3组T2DM患者血清PARP均较NC组高[(56.07±14.05)vs(73.99±10.69)vs(86.18±11.23)vs(34.60±9.21)pg/ml,P<0.01]。相关分析显示,血清PARP与UACR、Fg、3-NT、MCP-1、TGF-β1呈正相关(r=0.484、0.618、0.854、0.899、0.693,P<0.05)。多元逐步回归分析显示,Fg、UACR是影响血清PARP的独立危险因素(P<0.05),回归方程为Y_(PARP)=13.004+3.693X_(Fg)+0.02X_(uAcR)。结论 T2DM患者血清PARP水平与CKD肾脏损伤有一定联系,可能成为早期诊断CKD的新型生物学标志物。PARP参与CKD肾脏损伤可能涉及氧化应激、慢性炎性反应、肾脏纤维化、纤溶系统紊乱等机制。
Objective To study the changes and clinical significance of serum poly ADP ribose polymerase (PARP) level in patients with different stages of diabetic chronic kidney disease (CKD). Methods A total of 195 T2DM patients were collected and divided into UACR <30 mg / g group, UACR 30 ~ 300 mg / g group and UACR> 300 mg / g group according to urinary albumin / creatinine (UACR) 68 as a normal control (NC) group. The specimens were collected to detect the levels of PARP, fibrinogen (Fg), 3-nitrotyrosine (3-NT), monocyte chemoattractant protein-1 (MCP-1) and TGF- regression analysis. Results Serum PARP in T2DM patients was significantly higher than NC group [(56.07 ± 14.05) vs (73.99 ± 10.69) vs (86.18 ± 11.23) vs (34.60 ± 9.21) pg / ml, P <0.01; Correlation analysis showed that serum PARP was positively correlated with UACR, Fg, 3-NT, MCP-1 and TGF-β1 (r = 0.484,0.618,0.854,0.899,0.693, P <0.05). Multivariate stepwise regression analysis showed that Fg and UACR were independent risk factors affecting serum PARP (P <0.05). The regression equation was Y PARP = 13.004 + 3.693X Fg + 0.02X uAcR. Conclusions The level of serum PARP in T2DM patients is related to the renal damage of CKD, which may be a new biomarker for early diagnosis of CKD. The involvement of PARP in kidney injury of CKD may involve mechanisms such as oxidative stress, chronic inflammatory reaction, renal fibrosis, and fibrinolytic system disorders.