中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
25期
7-9
,共3页
糖尿病肾病%内皮,血管%不对称性二甲基精氨酸
糖尿病腎病%內皮,血管%不對稱性二甲基精氨痠
당뇨병신병%내피,혈관%불대칭성이갑기정안산
Diabetic nephropathies%Endothelium,vascular%Asymmetric dimethylarginine
目的 探讨不同白蛋白尿水平的2型糖尿病肾病患者血清不对称性二甲基精氨酸(ADMA)与血管内皮损伤的相关性.方法 将81例2型糖尿病肾病患者按尿白蛋白排泄率(UAER)分为微量白蛋白尿组(UAER 21～199 mg/24h,38例)和大量白蛋白尿组(UAER≥200 mg/24h,43例),另选择20例健康体检者作为对照组,均应用彩色多普勒超声诊断仪检测右前臂桡动脉内膜-中层厚度和内皮舒张功能,并采用酶联免疫吸附法测定血清ADMA.结果 三组桡动脉腔内径及内膜-中层厚度比较差异无统计学意义(P＞0.05)；微量白蛋白尿组、大量白蛋白尿组内皮依赖性舒张功能(EDD)和非内皮依赖性舒张功能(EID)均明显低于对照组[(10.45±2.58)％、(7.56±2.17)％比(15.72±3.05)％、(15.42±2.71)％、(15.37±2.92)％比(19.31±3.76)％],大量白蛋白尿组EDD明显低于微量白蛋白尿组,差异均有统计学意义(P＜0.05).微量白蛋白尿组、大量白蛋白尿组血清ADMA均明显高于对照组[(0.63±0.08)、(0.92±0.12)μmol/L比(0.39±0.05)μmol/L],大量白蛋白尿组明显高于微量白蛋白尿组,差异均有统计学意义(P＜0.05).2型糖尿病肾病患者血清ADMA与EDD呈负相关(r=-0.81,P=0.020),与C反应蛋白呈正相关(r=0.75,P=0.034).结论 2型糖尿病肾病患者血清ADMA显著升高,其升高与动脉内皮功能损伤密切相关.
目的 探討不同白蛋白尿水平的2型糖尿病腎病患者血清不對稱性二甲基精氨痠(ADMA)與血管內皮損傷的相關性.方法 將81例2型糖尿病腎病患者按尿白蛋白排洩率(UAER)分為微量白蛋白尿組(UAER 21～199 mg/24h,38例)和大量白蛋白尿組(UAER≥200 mg/24h,43例),另選擇20例健康體檢者作為對照組,均應用綵色多普勒超聲診斷儀檢測右前臂橈動脈內膜-中層厚度和內皮舒張功能,併採用酶聯免疫吸附法測定血清ADMA.結果 三組橈動脈腔內徑及內膜-中層厚度比較差異無統計學意義(P＞0.05)；微量白蛋白尿組、大量白蛋白尿組內皮依賴性舒張功能(EDD)和非內皮依賴性舒張功能(EID)均明顯低于對照組[(10.45±2.58)％、(7.56±2.17)％比(15.72±3.05)％、(15.42±2.71)％、(15.37±2.92)％比(19.31±3.76)％],大量白蛋白尿組EDD明顯低于微量白蛋白尿組,差異均有統計學意義(P＜0.05).微量白蛋白尿組、大量白蛋白尿組血清ADMA均明顯高于對照組[(0.63±0.08)、(0.92±0.12)μmol/L比(0.39±0.05)μmol/L],大量白蛋白尿組明顯高于微量白蛋白尿組,差異均有統計學意義(P＜0.05).2型糖尿病腎病患者血清ADMA與EDD呈負相關(r=-0.81,P=0.020),與C反應蛋白呈正相關(r=0.75,P=0.034).結論 2型糖尿病腎病患者血清ADMA顯著升高,其升高與動脈內皮功能損傷密切相關.
목적 탐토불동백단백뇨수평적2형당뇨병신병환자혈청불대칭성이갑기정안산(ADMA)여혈관내피손상적상관성.방법 장81례2형당뇨병신병환자안뇨백단백배설솔(UAER)분위미량백단백뇨조(UAER 21～199 mg/24h,38례)화대량백단백뇨조(UAER≥200 mg/24h,43례),령선택20례건강체검자작위대조조,균응용채색다보륵초성진단의검측우전비뇨동맥내막-중층후도화내피서장공능,병채용매련면역흡부법측정혈청ADMA.결과 삼조뇨동맥강내경급내막-중층후도비교차이무통계학의의(P＞0.05)；미량백단백뇨조、대량백단백뇨조내피의뢰성서장공능(EDD)화비내피의뢰성서장공능(EID)균명현저우대조조[(10.45±2.58)％、(7.56±2.17)％비(15.72±3.05)％、(15.42±2.71)％、(15.37±2.92)％비(19.31±3.76)％],대량백단백뇨조EDD명현저우미량백단백뇨조,차이균유통계학의의(P＜0.05).미량백단백뇨조、대량백단백뇨조혈청ADMA균명현고우대조조[(0.63±0.08)、(0.92±0.12)μmol/L비(0.39±0.05)μmol/L],대량백단백뇨조명현고우미량백단백뇨조,차이균유통계학의의(P＜0.05).2형당뇨병신병환자혈청ADMA여EDD정부상관(r=-0.81,P=0.020),여C반응단백정정상관(r=0.75,P=0.034).결론 2형당뇨병신병환자혈청ADMA현저승고,기승고여동맥내피공능손상밀절상관.
Objective To investigate the correlation between asymmetric dimethylarginine (ADMA) and endothelial dysfunction in patients with type 2 diabetic nephropathy.Methods The 81 patients with type 2 diabetic nephropathy were selected.According to the urinary albumin excretion rate (UAER),the patients were divided into micro-albuminuria group (DN1 group,UAER 21-199 mg/24 h,38 cases) and macro-albuminuria group (DN2 group,UAER ≥ 200 mg/24 h,43 cases).The 20 healthy people were defined as control group.Intimal-media thickness and endothelial dysfunction of the radial artery of right forearm were detected by color Doppler ultrasound.The serum level of ADMA was determined by enzyme-linked immunosorbent assay.Results There was no significant difference in radial artery inner diameter intimal-media thickness among the 3 groups (P ＞ 0.05).The Endothelial dependent diastolic function (EDD) and endothelial independent diastolic function (EID) in DN1 group and DN2 group were significantly lower than those in control group [(10.45 ± 2.58)％ and (7.56 ± 2.17)％ vs.(15.72 ± 3.05)％,(15.42 ± 2.71)％ and (15.37 ± 2.92)％ vs.(19.31 ± 3.76)％,P ＜ 0.05],and the EDD in DN2 group was significantly lower than that in DN1 group (P＜ 0.05).The serum ADMA in DN1 group and DN2 group was significantly higher than that in control group [(0.63 ± 0.08) and (0.92 ± 0.12) μ mol/L vs.(0.39 ± 0.05)μmol/L,P ＜0.05],and in DN2 group it was significantly higher than that in DN1 group (P ＜0.05).In patients with type 2 diabetic nephropathy,the serum ADMA and EDD had negative correlation (r =-0.81,P =0.020),but the serum ADMA and C reactive protein had positive correlation (r =0.75,P =0.034).Conclusions The serum level of ADMA is significantly increased in patients with type 2 diabetic nephropathy.There is a close correlation between ADMA and endothelial dysfunction of artery.
