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目的：探讨尿微量白蛋白阴性2型糖尿病（T2DM）患者肿瘤坏死因子受体1（TNFR1）、TNFR2含量与肾功能损害程度的关系。方法将90例尿微量白蛋白阴性（24 h 尿白蛋白排泄率＜20μg／min）T2DM患者按肾小球滤过率（eGFR）水平分为三组，eGFR ＞90 mL·min －1·（1．72 m2）－1、eGFR 60-90 mL·min －1· （1．72 m2）－1和 eGFR ＜60 mL·min －1·（1．72 m2）－1各30例，测定血清 TNFR1、TNFR2水平，同时记录相关临床指标，进行统计学分析。结果尿微量白蛋白阴性 T2DM患者血清 TNFR1、TNFR2水平与 eGFR 呈负相关关系（r ＝－0.428、－0．335，均 P ＜0．05），与血肌酐（Scr）呈正相关（r ＝0．476、0．225，均 P ＜0．05）。同时病程、尿素氮（BUN）、Scr、血清胱抑素 C（CysC）、α1微球蛋白（α1-MG）、β2微球蛋白（β2-MG）随肾功能损害程度加重而升高，各组间差异均有统计学意义（F ＝3．758、5．851、71.738、25．751、7．530、13．735，均 P ＜0．05）。Logistic 回归分析显示，TNFRs 是尿微量白蛋白阴性 T2DM患者肾功能损伤的独立危险因素（OR ＝2．009、1.143，均 P ＜0.05）。结论TNFRs 可能参与尿微量白蛋白阴性 T2DM患者肾损伤的发生、发展，可在一定程度上反映这些患者的肾功能损伤程度，或可作为一项常规监测糖尿病肾损伤的指标。“,”Objective To discuss the correlation of serum TNFR level with renal function injury in patients with type 2 diabetes mellitus (T2DM)and normal albumin excretion.Methods 90 T2DMpatients with normal albu-min excretion(24h urine albumin excretion rate 90mL · min -1 · (1.72m2 )-1 ,eGFR 60 -90mL · min -1 · (1.72m2 )-1 and eGFR <60mL·min -1 ·(1.72m2 )-1 ,30 cases in each group.The serum TNFRs level and related clinical data were measured and analyzed statistically.Results The levels of serum TNFR1,TNFR2 were negatively correlated with eGFR(r =-0.428,-0.335,all P <0.05),and positively correlated with Scr(r =0.476,0.225,all P <0.05)in patients with T2DM and normal albumin excretion.The course of disease and the levels of BUN,Scr, CysC,α1 -MG,β2 -MG were increased as the degree of renal function injury.All these index had statistically signifi-cant differences in three groups(F =3.758,5.851,71.738,25.751,7.530,13.735,all P <0.05).Logistic regres-sion analysis showed that the levels of serum TNFR1,TNFR2 were independent risk factors for renal impairment in patients with T2DMand normal albumin excretion(OR =2.009,1.143,all P <0.05).Conclusion TNFRs may be involved in the development and progression of renal impairment,and may become a new conventional indicator for DN because of reflecting the degree of renal function injury in some extent in T2DMpatients with normal albumin excretion.