目的探讨糖尿病肾病不同时期血浆超氧化物歧化酶(SOD)和T细胞免疫球蛋白域黏蛋白域蛋白-1(Tim-1)表达水平变化。方法根据24h尿清蛋白排泄率将120例糖尿病患者分为单纯糖尿病组、早期糖尿痛肾病组以及临床糖尿病肾病组。用AU5800检测120例糖尿病肾病各分期和45例体检健康者血浆SOD、Cr和CysC的表达水平,ELISA法检测血浆Tim-1含量。结果与对照组相比,血浆SOD在单纯糖尿病组中的表达水平无明显变化(136.0±18.4)U/mL,而在早期糖尿病肾病组(117.0±25.1)U/mL和临床糖尿病肾病组(103.5±22.1)U/mL中的表达水平显著降低(P〈0.05);与对照组和单纯糖尿病组相比,血浆Tim-1、Cr及CysC在临床糖尿病肾病组中的表达均显著升高(P〈0.05)。SOD浓度与尿清蛋白排泄率呈负相关(P〈0.01),Tim-1、Cr和CysC浓度与尿清蛋白排泄率呈显著的正相关(P均〈0.01)。结论血浆SOD和Tim一1表达水平与肾功能受损程度密切相关,可作为动态监测糖尿病肾病发展的敏感指标;血浆Cr和CysC的表达水平升高在反映糖尿病肾病肾功能受损中起辅助作用,为指导临床治疗提供理论依据。
Objective To investigate the changes of plasma expression levels of SOD and Tim-1 in the different stages of diabetic ne- phropathy. Methods A total of 120 patients with diabetes mellitus were classified as simple diabetes group, early diabetic nephropa- thy group and clinical diabetic nephropathy group according to urine albumin excretion rate in 24 hours. The expression levels of SOD, creatinine (Cr) and cysteine C (CysC) in plasma of the 120 patients and 45 healthy controls were analyzed by AU5800 and the levels of Tim-1 in plasma were detected by ELISA. Results Compared with control group, the expression level of SOD in plasma showed no significant change in simple diabetes group ( 136.0 ± 18.4) U/mL, while it was declined obviously in early diabetic nephropathy group (117.0 ± 25.1 ) U/mL and clinical diabetic nephropathy group (103.5 ± 22.1 ) U/mL (P 〈 0.05 ). Compared with control group and simple diabetes group, the plasma levels of Tim-1, Cr and CysC in clinical diabetic nephropathy group were obviously high ( P 〈 0.05). The level of SOD and urine albumin excretion rate showed significantly negative correlation(P 〈 0.01 ). The levels of Tim-l, Cr and CysC showed notably positive correlation with urine albumin excretion rate ( all P 〈 0.01 ). Conclusion The levels of SOD and Tim-1 were closely correlated with the extent of kidney damage, promising served as the markers for monitoring dynamically the devel- opment of diabetic nephropathy. The increased expression levels of Cr and CysC in plasma may play supplementary role for reflecting the impaired renal function in diabetic nephropathy, providing theoretical basis for guiding clinical treatment.