中文摘要：

目的： Meta分析TNF‐α水平与不同分期糖尿病慢性肾脏疾病（CKD）的关系。方法通过计算机检索，收集有关CKD患者血清TNF‐α水平的文献，采用Rev Man 4.2软件进行Meta分析，合并结果以标准化均数差（SMD）表示。结果本研究共纳入15篇文献。Meta分析结果显示，早期CKD组血清TNF‐α水平高于正常对照（NC）组[SWD＝9.14，95％ CI（7.57～10.72），P＜0.00001]和单纯糖尿病组[SWD＝5.17，95％ CI （4.27～6.06），P＜0.00001]。临床期CKD组血清TNF‐α水平高于早期CKD组[SWD＝11.09，95％ CI（8.25～13.93），P＜0.00001]。结论现有临床研究证据显示，CKD患者血清TNF‐α水平增高，且血清TNF‐α含量随糖尿病严重程度升高，血清TNF‐α测定对判断CKD的病情有指导意义。

英文摘要：

Objective To explore the relationship between serum level of tumor necrosis factor‐α（TNF‐α）and diabetic patients with different stages of chronic kidney disease （CKD ）. Methods Electronic search strategy was carried out to collect data of TNF‐αin patients with CKD. Review manager 4.2 was used and pooled data were expressed as standardized mean difference （SMD）. Results A total of 15 studies were enrolled in this study. Meta analysis showed that serum TNF‐αlevel was significantly higher in patients with early stage of CKD than in NC group [SW D=9.14 ,95% CI（7.57～10.72 ） ,P＆lt;0.00001]. The serum TNF‐αlevel was significantly higher in patients with early stage of CKD than in DM group[SW D= 5.17 ,95% CI （4.27 ～ 6.06 ） ,P〈 0.00001 ]. The serum TNF‐α level was significantly higher in patients with clinical protein uria than in patients with early stage of CKD [SW D=11.09 ,95% CI （8.25～13.93） ,P〈0.00001]. Conclusion Clinical evidence shows that TNF‐α is increased in patients with CKD.The higher the serum TNF‐α level the patients have ,the more serious CKD will be.Measurement of TNF‐αmay facilitate the evaluation of the severity of CKD.