中文摘要：

目的探讨尿液足细胞（PC）排泄与糖尿病肾病（DN）进展的相关性及糖尿病状态下PC损伤的危险因素。方法73例2型糖尿病（T2DM）患者，其中正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组各20例，肾功能衰竭组13例;20例正常对照组。间接免疫荧光法Podocalyxin多克隆抗体标记、计数尿PC。监测血压、糖化血红蛋白（HbA1c）、甘油三酯（TG）、总胆固醇（TC）、血肌酐（Scr）等指标。结果（1）正常白蛋白尿、肾功能衰竭、正常对照各组尿PC中位数为0，大量白蛋白尿组尿PC较微量白蛋白尿组明显增多[2.62（0～7.2）cells/ml比1.28（0～3.72）cells/ml，P〈0.05];（2）尿PC与UAER、TC、收缩压、舒张压、HbA1c和病程均呈等级正相关，但尿PC阳性组与阴性组间仅收缩压和TC差异有统计学意义。多元逐步回归分析显示影响尿PC排泄的因素仅有收缩压（r=0.527，P〈0.01）和TC（r=0.421，P〈0.01）。结论PC损伤脱落参与DN的发生和进展，高血压和高血脂是糖尿病状态下PC损伤的重要危险因素。

英文摘要：

Objective To determine whether there is a relationship between the excretion of urinary podocytes（PC） and the progression of diabetic nephropathy（DN） and to investigate the risk factors for podocyte excretion in diabetic patients. Methods 73 type 2 diabetic subjects, including group A, 20 with normoalbuminuria; group B, 20 with microalbuminuria; group C, 20 with macroalbuminuria and group D, 13 with chronic renal failure, and 20 normal control （group E） were studied. Indirect immunofluorescene with polyclonal antibody against podocalyxin was used to detect urinary PC and the number of podocytes was counted under fluorescence microscope. Plasma total cholesterol,triglycerides,serum creatinine and glycohemoglobin were measured and blood pressure was also recorded. Results （1） Podocytes were absent in the urine of patients in group A, D and E. The amount of urinary PC in group C was apparently more than that in group B [2.62（0-7.2）cells/ml versus 1.28（0-3. 7）cells/ml, P〈0. 05]. （3） There was a positive correlation of urinary PC with some clinical indexes such as UAER, TC, systolic blood pressure （SBP）, diastolic blood pressure（DBP）, HbA1 c and duration. However, only SBP and TC in patients with detectable urinary PC were significantly different from ones in patients without urinary PC. Stepwise regression analysis revealed that only SBP and TC had a close relationship with urinary excretion of podocytes. Conclusions Podocytes can be detected in urine of DN patients and may be a marker of early stage and severity of DN. High SBP and hypercholesterolemia are important risk factors for type 2 diabetic nephropathy.