CAJ | 학술논문

目的：观察血清中细胞间黏附分子1(intercellular adhesion molecule 1,ICAM-1)、晚期氧化蛋白产物((advance oxidative protein products,AOPP)在不同尿蛋白排泄率的糖尿病肾脏疾病(diabetic kidney disease,DKD)患者体内的水平,探讨血清 ICAM-1、AOPP 在 DKD的发生、发展中的作用。方法将62例2型糖尿病患者依据尿微量白蛋白排泄率(urine cdbumin excretion rate, UAER)分为正常白蛋白(UAER<20μg/min)20例(正常组)、微量蛋白尿(20μg/min <UAER<200μg/min)22例(微量组)、显性白蛋白尿(UAER>200μg/min)20例(显性组),所有患者被诊断有DKD在3年以内(含3年),近3个月无心肌梗塞、脑梗塞等疾病,排除急慢性感染、各类肾炎、尿路感染、肾血管疾病,停用影响血小板药物如潘生丁、非甾体抗炎药1周,抽血时,血压控制在135/85 mm Hg以下。另选择健康体检正常者20例(对照组),无高血压及内分泌代谢病,无心、肝、肾、脑病史。UAER均采用化学发光法测定,用夹心法酶联免疫吸附检测各组中 ICAM-1、AOPP 的水平。结果3组糖尿病患者 ICAM-1、AOPP水平均高于对照组,差异均有统计学意义(P<0.05)；显性组 ICAM-1、AOPP水平高于微量组、正常组(P<0.01)；微量组 ICAM-1、AOPP 水平高于正常组(P<0.05)。血清ICAM-1与AOPP呈正相关(r=0.770,P<0.01),血清ICAM-1、AOPP水平与UAER呈正相关(r=0.805、0.811,P<0.01)。结论血清 ICAM1、AOPP 可成为 DKD 的早期预测因子,与 UAER联合检测有助于早期诊断DKD,对其进行早期干预在预防DKD中有重要意义。
목적：관찰혈청중세포간점부분자1(intercellular adhesion molecule 1,ICAM-1)、만기양화단백산물((advance oxidative protein products,AOPP)재불동뇨단백배설솔적당뇨병신장질병(diabetic kidney disease,DKD)환자체내적수평,탐토혈청 ICAM-1、AOPP 재 DKD적발생、발전중적작용。방법장62례2형당뇨병환자의거뇨미량백단백배설솔(urine cdbumin excretion rate, UAER)분위정상백단백(UAER<20μg/min)20례(정상조)、미량단백뇨(20μg/min <UAER<200μg/min)22례(미량조)、현성백단백뇨(UAER>200μg/min)20례(현성조),소유환자피진단유DKD재3년이내(함3년),근3개월무심기경새、뇌경새등질병,배제급만성감염、각류신염、뇨로감염、신혈관질병,정용영향혈소판약물여반생정、비치체항염약1주,추혈시,혈압공제재135/85 mm Hg이하。령선택건강체검정상자20례(대조조),무고혈압급내분비대사병,무심、간、신、뇌병사。UAER균채용화학발광법측정,용협심법매련면역흡부검측각조중 ICAM-1、AOPP 적수평。결과3조당뇨병환자 ICAM-1、AOPP수평균고우대조조,차이균유통계학의의(P<0.05)；현성조 ICAM-1、AOPP수평고우미량조、정상조(P<0.01)；미량조 ICAM-1、AOPP 수평고우정상조(P<0.05)。혈청ICAM-1여AOPP정정상관(r=0.770,P<0.01),혈청ICAM-1、AOPP수평여UAER정정상관(r=0.805、0.811,P<0.01)。결론혈청 ICAM1、AOPP 가성위 DKD 적조기예측인자,여 UAER연합검측유조우조기진단DKD,대기진행조기간예재예방DKD중유중요의의。
Objective To observe the changes of plasma levels of intercellular adhesion mole-cule-1 (ICAM-1 )and advance oxidative protein products (AOPP)in patients with different urinary al-bumin stages of diabetic kidney disease (DKD)and the roles that they play in the onset and progres-sion of DKD.Methods Sixty-two patients with type 2 diabetic mellitus were divided into three groups:normal urine albumin group (n=20),urine micro-amount albumin group (n=22),and urine dominancy albumin group (n=20)according to their urine albumin excretion rate (UAER).Twenty healthy subj ects served as controls.Serum ICAM-1 and AOPP were measured by enzyme-linked-im-munosorbent assay (ELISA).Results (1 )The concentrations of serum ICAM-1 and AOPP in the three type 2 diabetic mellitus groups were higher than in the control group (P<0.05),higher in the urine dominancy albumin group than in the urine micro-amount albumin and normal urine albumin groups (P<0.01).The concentrations of serum ICAM-1 and AOPP in the urine micro-amount albu-min group were higher than in the normal urine albumin group (P<0.05).There was a positive cor-relation between serum ICAM-1 and AOPP (P<0.01),and the concentrations of ICAM-1 and AOPP were positively correlated with UAER respectively (P<0.01 ).Conclusions The plasma levels of ICAM-1 and AOPP were sensitive markers for early diagnosis of DKD and correlated positively with the onset and progression of DKD.The test of plasma levels of ICAM-1 ,AOPP and UAER was prob-ably useful for early diagnosis of DKD.