摘要
目的:观察不同期DN患者肾小球电荷屏障的变化及与Hb A1c相关性。方法:80例DM住院患者分为4组:DM正常白蛋白尿组(n=20)、DNⅢ期组(n=20),DNⅣ期组(n=20)和DNⅤ期组(n=20),另选性别、年龄大致相匹配的健康志愿者作为健康对照组(n=20)。测定各组血清和尿液中胰淀粉酶、唾液粉酶含量,比较各组胰淀粉酶清除率(CPAM)与唾液淀粉酶清除率(CSAM)的比值(CPAM/CSAM),评估各组肾小球电荷屏障的变化情况。应用双变量线性相关分析CPAM/CSAM与Hb A1c的相关性。结果:各组中CPAM/CSAM值DM正常白蛋白尿组、DNⅢ期组和DNⅣ组间两两比较差异均有统计学意义(P<0.05);DM正常白蛋白尿组与健康对照组间差异无统计学意义(P>0.05),DNⅣ期组与DNⅤ期组间差异无统计学意义(P>0.05)。CPAM/CSAM值与Hb A1c具有负相关性(r=-0.78,P<0.05)。结论:DM患者随着DN病程的进展,肾小球电荷屏障损伤逐渐加重,降低Hb A1c或能延缓肾小球电荷屏障的损伤。
Objective： To observe the change of glomerular charge barrier in different stages of diabetic nephropathy （DN） and its correlation with HbAlc. Methods： 80 hospitalized patients with diabetes meUims （DM） were divided into four groups： 20 diabetic patients with normal urinary albumin excretion, 20 patients with DN in stage IU, 20 patients with DN in stage Ⅳ and 20 patients with DN in stage Ⅴ. And 20 healthy volunteers with similar age and sex were chosen as the control group. Then pancreatic amylase and salivary amylase of serum and urine in each group were determined and CPAM/CSAM was calculated for evaluating the changes of glomerular charge barrier in each group. Next, the means of CPAM / CSAM among different groups were compared, and the correlation between CPAM/CSAM and HbAlc was analyzed. Results： There were significant differences among three groups： DM with normal urinary albumin excretio, DN in stage Ⅲ and DN in stage Ⅳ（ P〈 0.05）;there was no significant difference between the DM group with normal urinary albumin excretio and the control group （P〉0.05）; and there was no statistical difference between the DN groups in stage 1V and DN group in stage V （P〉0.05）. Moreover, there was a negative correlation between the value of CPAM/CSAM and HbAlc （r = -0.78, P〈 0.05 ）. Conclusion： With the progress of the DN course, the damage of glomerular charge barrier of the DM patients becomes worse and worse. Therefore, to a certain degree, the reduction of HbAlc may delay the damage of glomerular charge barrier.
出处
《华夏医学》
CAS
2016年第4期55-58,共4页
Acta Medicinae Sinica
