CAJ | 학술논문

背景:糖尿病肾病(diabetic nephropathy,DN)与血管紧张素Ⅰ转换酶(angiotensinⅠ-converting enzyme,ACE)基因多态性关系密切,血清ACE活性增高是DN发生发展的危险因素.然而ACE是否与DN肾虚证的发生有关目前尚未清楚.目的:探讨DN肾虚证与血清ACE活性的关系.设计:以诊断为依据的病例对照研究.地点、对象和方法:选择解放军第一军医大学南方医院内分泌科确诊为DN的住院87例患者为研究对象.依据肾虚证诊断标准对患者进行中医辨证,分为肾气虚组(26例)、肾阴虚组(20例)、肾阳虚组(18例)以及对照组(非肾虚患者,23例).对所有受试者进行ACE活性测定主要观察指标各组DN患者血清ACE活性比较.结果:非肾虚组、肾气虚组、肾阴虚组和肾阳虚组DN患者血清ACE活性分别为(413±112),(492±142),(632±153),(654±125)nkat.非肾虚组与其他3组比较,差异有显著性意义(P＜0.05),肾阴虚组、肾阳虚组与其他两组比较,差异有显著性意义(P＜0.01).肾阴虚组、肾阳虚组比较,差异无显著性意义(P＞0.05).结论:DN患者血清ACE活性与肾虚证的发生发展密切相关,血清ACE活性可能是DN容易发生肾虚证的物质基础.
배경:당뇨병신병(diabetic nephropathy,DN)여혈관긴장소Ⅰ전환매(angiotensinⅠ-converting enzyme,ACE)기인다태성관계밀절,혈청ACE활성증고시DN발생발전적위험인소.연이ACE시부여DN신허증적발생유관목전상미청초.목적:탐토DN신허증여혈청ACE활성적관계.설계:이진단위의거적병례대조연구.지점、대상화방법:선택해방군제일군의대학남방의원내분비과학진위DN적주원87례환자위연구대상.의거신허증진단표준대환자진행중의변증,분위신기허조(26례)、신음허조(20례)、신양허조(18례)이급대조조(비신허환자,23례).대소유수시자진행ACE활성측정주요관찰지표각조DN환자혈청ACE활성비교.결과:비신허조、신기허조、신음허조화신양허조DN환자혈청ACE활성분별위(413±112),(492±142),(632±153),(654±125)nkat.비신허조여기타3조비교,차이유현저성의의(P＜0.05),신음허조、신양허조여기타량조비교,차이유현저성의의(P＜0.01).신음허조、신양허조비교,차이무현저성의의(P＞0.05).결론:DN환자혈청ACE활성여신허증적발생발전밀절상관,혈청ACE활성가능시DN용역발생신허증적물질기출.
BACKGROUND: There is a close relationship between diabetic nephropathy(DN) and gene polymorphism of angiotensin-I-converting-enzyme gene (ACE), and the increase of serumal ACE activity is a risk factor of DN. However, so far the role of ACE in kidney deficiency of diabetic nephropathy is unclear.OBJECTIVE: To investigate the relationship between the activity of serumal ACE and kidney deficiency of DN.DESIGN: A case-controlled study based on diagnosis was carried out.SETTING and PARTICIPANTS: Patients with DN were recruited from the Department of Endocrinology of Nanfang Hospital, First Military Medical University of Chinese PLA.INTERVENTIONS: A total of 87 patients with DN were divided into four groups according to diaganostic standard of kidney deficiency: 23 non-kidney deficiency, 26 kidney qi-deficiency, 20 kidney yin-deficiency and 18 kidney yang-deficiency.MAIN OUTCOME MEASURES: Serumal ACE activity of the patients was detected with spectrophotometry.RESULTS: Serumal ACE activity of the patients with non-kidney deficiency, kidney qi-deficiency, kidney yin-deficiency and kidney yang-deficiency were(413 ± 112), (492 + 142), (632 ± 153) and(654 +125 ) nkatal, respectively. ACE activity in non-kidney deficiency group was significantly lower than that in other groups( P ＜ 0.05); ACE activity in kidney yin-deficiency group and in kidney yang-deficiency group were markedly higher than that in other groups( P ＜ 0.01), but there was no difference between kidney yin-deficiency group and kidney yang-deficiency group ( P ＞ 0.05 ).CONCLUSION: It is suggested that there is a close relationship between serumal ACE activity and the occurrence and development of kidney deficiency in patients with DN, which may be its material foundation.