中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2014年
1期
1-5
,共5页
孟祥龙%丁涵露%张渊%李贵森%洪大情%李春梅%张亚玲%王莉
孟祥龍%丁涵露%張淵%李貴森%洪大情%李春梅%張亞玲%王莉
맹상룡%정함로%장연%리귀삼%홍대정%리춘매%장아령%왕리
糖尿病肾病%动脉粥样硬化%内皮细胞%活化蛋白C
糖尿病腎病%動脈粥樣硬化%內皮細胞%活化蛋白C
당뇨병신병%동맥죽양경화%내피세포%활화단백C
Diabetic nephropathies%Atherosclerosis%Endothelial cells%Activated protein C
目的 探讨2型糖尿病肾病患者血浆活化蛋白C(APC)水平变化与动脉粥样硬化(AS)形成之间的关系,揭示AS形成的可能机制.方法 ELISA法检测30例非透析2型糖尿病肾病患者(糖尿病肾病组)和26例健康志愿者(对照组)血浆APC、可溶性血管细胞黏附分子1 (sVCAM-1)、可溶性血管内皮细胞蛋白C受体(sEPCR)、可溶性血栓调节蛋白(sTM)水平,彩色多普勒超声测量颈动脉内-中膜厚度(IMT).结果 2型糖尿病肾病患者血浆APC水平显著低于对照组[(2 865.99±571.38) ng/L比(3 227.70±300.44) ng/L,P=0.005].APC与IMT、24 h尿白蛋白量、sEPCR、sVCAM-1、sTM呈负相关(r=-0.720、-0.402、-0.477、-0.437、-0.505,均P＜0.05).单因素方差分析显示不同程度蛋白尿组及不同程度IMT组患者APC水平差异均有统计学意义(均P＜ 0.05).结论 2型糖尿病肾病患者血浆APC水平与病情严重度和IMT呈负相关,下降的血APC可能致炎性介质水平升高及内皮细胞损伤而参与糖尿病肾病AS的发生发展.
目的 探討2型糖尿病腎病患者血漿活化蛋白C(APC)水平變化與動脈粥樣硬化(AS)形成之間的關繫,揭示AS形成的可能機製.方法 ELISA法檢測30例非透析2型糖尿病腎病患者(糖尿病腎病組)和26例健康誌願者(對照組)血漿APC、可溶性血管細胞黏附分子1 (sVCAM-1)、可溶性血管內皮細胞蛋白C受體(sEPCR)、可溶性血栓調節蛋白(sTM)水平,綵色多普勒超聲測量頸動脈內-中膜厚度(IMT).結果 2型糖尿病腎病患者血漿APC水平顯著低于對照組[(2 865.99±571.38) ng/L比(3 227.70±300.44) ng/L,P=0.005].APC與IMT、24 h尿白蛋白量、sEPCR、sVCAM-1、sTM呈負相關(r=-0.720、-0.402、-0.477、-0.437、-0.505,均P＜0.05).單因素方差分析顯示不同程度蛋白尿組及不同程度IMT組患者APC水平差異均有統計學意義(均P＜ 0.05).結論 2型糖尿病腎病患者血漿APC水平與病情嚴重度和IMT呈負相關,下降的血APC可能緻炎性介質水平升高及內皮細胞損傷而參與糖尿病腎病AS的髮生髮展.
목적 탐토2형당뇨병신병환자혈장활화단백C(APC)수평변화여동맥죽양경화(AS)형성지간적관계,게시AS형성적가능궤제.방법 ELISA법검측30례비투석2형당뇨병신병환자(당뇨병신병조)화26례건강지원자(대조조)혈장APC、가용성혈관세포점부분자1 (sVCAM-1)、가용성혈관내피세포단백C수체(sEPCR)、가용성혈전조절단백(sTM)수평,채색다보륵초성측량경동맥내-중막후도(IMT).결과 2형당뇨병신병환자혈장APC수평현저저우대조조[(2 865.99±571.38) ng/L비(3 227.70±300.44) ng/L,P=0.005].APC여IMT、24 h뇨백단백량、sEPCR、sVCAM-1、sTM정부상관(r=-0.720、-0.402、-0.477、-0.437、-0.505,균P＜0.05).단인소방차분석현시불동정도단백뇨조급불동정도IMT조환자APC수평차이균유통계학의의(균P＜ 0.05).결론 2형당뇨병신병환자혈장APC수평여병정엄중도화IMT정부상관,하강적혈APC가능치염성개질수평승고급내피세포손상이삼여당뇨병신병AS적발생발전.
Objective To investigate the relationship between plasma activated protein C (APC) and the development of atherosclerosis (AS),and illustrate the mechanism of AS in type 2 diabetic nephropathy.Methods A total of 30 non-dialysis patients of type 2 diabetic nephrology and 26 control subjects were enrolled.APC,soluble vascular adhesion molecular-1 (sVCAM-1),soluble endothelial cell protein C receptor (sEPCR) and soluble thrombomodulin (sTM) were assayed by ELISA.Carotid intima-media thickness (IMT) was measured by ultrasonography.Results APC levels were significantly decreased in type 2 diabetic nephropathy compared with that in controls [(2 865.99 ±571.38) ng/L vs (3 227.70±300.44) ng/L,P =0.005].APC levels had negative correlation with IMT,24 h albuminuria,sEPCR,sVCAM-1,sTM (r =-0.720,-0.402,-0.477,-0.437,-0.505,all P ＜ 0.05).Significant difference were observed in different proteinuria groups and IMT groups by ANOVA analysis (P＜O.05).Conclusions In type 2 diabetic nephropathy patients,plasma APC is negatively correlated with severity and IMT.Decreased plasma APC may lead to high levels of inflammatory mediators and endothelial cell injury,which may involved in the occurrence and development of atherosclerosis in diabetic nephropathy.
