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糖尿病肾病患者血清降钙素原水平及与其它指标间的关系

Higher Procalcitonin Level in Diabetic Nephropathy Patients Compared with Healthy Volunteers

  • 摘要: 目的 了解无感染的糖尿病肾病(DN)患者与健康志愿者间炎症标志物降钙素原(PCT)水平是否存在差异,并探讨其临床意义。 方法 检测76例单纯糖尿病患者〔DM组,24 h尿微量白蛋白(mALB)<30 mg/24 h〕、81例早期DN患者(EDN组,mALB 30~300 mg/24 h )、87例临床DN患者(DN组,mALB≥300 mg/24 h)、以及82例年龄和性别匹配的健康志愿者血清PCT水平,并检测炎症相关分子、肝、肾功能相关指标,分析DN患者血清PCT与其它检测指标间的关系。 结果 DN组患者的PCT〔(0.55±0.61) μg/L〕高于健康对照组、DM组和EDN组 (P<0.001或P<0.05)。 Spearman相关分析显示,DN患者血清PCT与血清乳酸脱氢酶(LDH, r=0.541,P<0.01)、血清尿酸(UA, r=0.320,P<0.01)、血清尿素(Urea, r=0.324, P<0.01)、血清肌酐(Cr, r=0.403, P<0.01)、血清α-羟丁酸脱氢酶(α-HBD, r=0.791, P<0.01)和血清C-反应蛋白(CRP, r=0.694, P<0.010)呈正相关,进一步行多重线性回归,发现LDH和Cr均与PCT水平相关,标准偏回归系数分别为0.591和0.329。与其它检测指标间尚未发现相关性。 结论 与健康志愿者相比,无明显感染迹象的DN患者血清PCT水平增高,这可能与微小炎症灶的存在以及肾脏功能受损相关。

     

    Abstract: Objective To investigate the difference of procalcitonin (PCT) level between uninfected diabetic nephropathy patients and healthy volunteers. Methods This study enrolled 76 patients with diabetes only 〔DM group, 24 h urinary micro albumin (mALB)<30 mg/24 h〕, 81 patients with early DN (EDN group, mALB 30-300 mg/24 h), 87 DN patients (DN group, mALB ≥ 300 mg/24 h), and 82 age- and sex-matched healthy volunteers. All the patients were free of systemic infection. PCT levels and various laboratory parameters including metabolic and kidney functions as well as inflammatory element profiles were assessed. Results The PCT level of DN group was significantly higher than that of healthy control group, DM group and EDN group (P<0.001 or P<0.05). Spearman’s test showed a significant positive correlation between PCT and serum lactate dehydrogenase (LDH, r=0.541, P<0.01), Urine acid (UA) ( r=0.320, P<0.01), Urea ( r=0.324, P<0.01), creatinine (Cr) ( r=0.403, P<0.01), α-hydroxybutyrate dehydrogenase (α-HBD) ( r=0.791, P<0.01) and C-reactive protein (CRP) ( r=0.694, P<0.001) in diabetic nephropathy patients respectively. Conclusion Serum PCT level of patients with diabetic nephropathy is higher than that of healthy volunteers, which may be associated with minimal inflammation and kidney function damage.

     

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