肿瘤坏死因子受体1和2与2型糖尿病早期肾损伤的相关性及其影响因素分析

发布时间：2018-04-14 01:37

  本文选题：2型糖尿病 + 早期肾损伤　； 参考：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨血清可溶性肿瘤坏死因子受体1(soluble tumor necrosis factor receptors 1,TNFRl)、血清可溶性肿瘤坏死因子受体2(soluble tumor necrosis factor receptors 1,TNFR2)与2型糖尿病早期肾损伤的关系;并探讨哪个受体和2型糖尿病肾损伤相关性更大及血清受体水平变化的影响因素,为2型糖尿病患者早期肾损伤诊断提供一定的参考价值。方法:应用病例对照研究,收集2016年4月至2016年10月前来山西省人民医院内分泌科门诊及病房诊疗的70例2型糖尿病病患组成实验组,半年内至少检测两次尿微量白蛋白/尿肌酐(mAIb/Cr),取其均值,根据mAIb/Cr均值分为A组:正常白蛋白尿组(mAIb/Cr30mg/g);B组:微量白蛋白尿组(mAIb/Cr 30~299mg/g);并收集同期在我院健康中心正常体检者38例组成C组:健康对照组。分别测定其血清可溶性TNFRl、TNFR2水平,并记录其他临床资料,进行统计学分析。结果:正常白蛋白尿组[TNFRl(2517.77±1475.54)pg/ml、TNFR2(841.97±493.67)pg/m1]与微量白蛋白尿组[TNFRl(4790.85±1613.22)pg/ml、TNFR2(1236.25±778.96)pg/m1]的水平较健康对照组[TNFRl(1800.90±1037.22)pg/ml、TNFR2(299.74±60.50)pg/m1]均升高(P0.001);在糖尿病患者中,微量白蛋白尿组较正常白蛋白尿组TNFR1、TNFR2水平升高(P0.001)。TNFR1、TNFR2与mAIb/Cr、年龄、空腹血糖、糖尿病病程呈正相关(P0.001),且TNFR1相关性更大;与估算肾小球滤过率(eGFR)、高密度脂蛋白胆固醇(HDL-C)呈负相关(P0.001),且TNFR1相关性更大。回归分析显示HDL-C对TNFR1、TNFR2的影响最大。结论:与健康对照组相比,正常白蛋白尿的2型糖尿病患者循环血中可溶性TNFRl、TNFR2浓度明显升高,且TNFR1升高更显著。血清TNFRl可能成为尿白蛋白阴性的2型糖尿病早期肾损伤的标志物。血清TNFR1的水平受HDL-C影响较大,临床中需要密切关注糖尿病人群的低HDL-C血症。
[Abstract]:Objective: to investigate the relationship between serum soluble tumor necrosis factor receptor 1(soluble tumor necrosis factor receptors 1 and serum soluble tumor necrosis factor receptor 2(soluble tumor necrosis factor receptors 1 TNFR2 in patients with type 2 diabetes mellitus.To explore which type 2 diabetic renal injury is more correlated with type 2 diabetes and the influence factors of serum receptor level, and to provide a certain reference value for the early diagnosis of renal injury in type 2 diabetes mellitus.Methods: from April 2016 to October 2016, 70 patients with type 2 diabetes mellitus in the Department of Endocrinology, Shanxi Provincial people's Hospital, were collected from a case-control study to form an experimental group.At least twice in half a year, urine microalbumin / urinary creatinine mAIb / Cr was detected, and its mean value was calculated.According to the mean value of mAIb/Cr, the patients were divided into group A: normal albuminuria group: normal albuminuria group: normal albuminuria group: group B: microalbuminuria group: mAIb / Cr 30cr 299mg / g group, and 38 cases of normal physical examination in the health center of our hospital at the same time were collected to form group C: healthy control group.The serum levels of soluble TNFR 2 were measured and other clinical data were recorded for statistical analysis.缁撴灉:姝ｅ父鐧借泲鐧藉翱缁刐TNFRl(2517.77卤1475.54)pg/ml,TNFR2(841.97卤493.67)pg/m1]涓庡井閲忕櫧铔嬬櫧灏跨粍[TNFRl(4790.85卤1613.22)pg/ml,TNFR2(1236.25卤778.96)pg/m1]鐨勬按骞宠緝鍋ュ悍瀵圭収缁刐TNFRl(1800.90卤1037.22)pg/ml,TNFR2(299.74卤60.50)pg/m1]鍧囧崌楂，

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