糖尿病肾病患者髓过氧化物酶水平与代谢指标的相关性

王凌云

【摘要】 目的：探讨糖尿病肾病患者髓过氧化物酶（myeloperoxidase，MPO）水平与代谢指标的相关性。方法：选取2018年8月-2020年10月在本院住院的糖尿病肾病患者72例（糖尿病肾病组）及同期于本院体检的健康人72名（对照组）作为研究对象，记录两组的一般资料，采用生化分析仪检测常规代谢指标，采用酶联免疫法检测血清MPO水平。比较两组一般资料、糖化血红蛋白（HbA1c）、空腹血糖（FBG）、尿素氮（BUN）、尿酸（UA）、胆固醇（TC）、甘油三酯（TG）、空腹胰岛素（FINS）、肌酐（Cr）、尿微量白蛋白及MPO。分析糖尿病肾病组中MPO与各代谢指标的相关性。结果：糖尿病肾病组HbA1c、FBG、Cr、BUN、UA、尿微量白蛋白均高于对照组（P<0.05）。糖尿病肾病组血清MPO水平高于对照组（P<0.05）。Pearson相关分析显示，糖尿病肾病组中MPO与HbA1c、FBG、Cr、BUN、UA、尿微量白蛋白均呈正相关（P<0.05）。多元逐步回歸分析显示，HbA1c、FBG、尿微量白蛋白为MPO的主要影响因素（P<0.05）。结论：MPO在糖尿病肾病患者中呈现高表达状况，与血糖、肾功能等代谢指标具有相关性，可能共同参与糖尿病肾病的发生发展过程。

【关键词】 髓过氧化物酶 糖尿病肾病 尿微量白蛋白

[Abstract] Objective： To investigate the correlation between myeloperoxidase （MPO） levels and metabolic indexes in patients with diabetic nephropathy. Method： A total of 72 diabetic nephropathy patients （diabetic nephropathy group） hospitalized in our hospital from August 2018 to October 2020 and 72 healthy people （control group） who underwent physical examination in our hospital during the same period were selected as the research objects. The general data of the two groups were recorded. Biochemical analyzer was used to detect routine metabolic indexes， and enzyme-linked immunoassay was used to detect serum MPO levels. General information， HbA1c， FBG， BUN， UA， TC， TG， FINS， Cr ， urinary microalbumin and MPO were compared between the two groups. The correlation between MPO and various metabolic indexes in diabetic nephropathy group was analyzed. Result： HbA1c， FBG， Cr， BUN， UA and urinary microalbumin in diabetic nephropathy group were higher than those in control group （P<0.05）. The serum MPO level of diabetic nephropathy group was higher than that of control group （P<0.05）. Pearson correlation analysis showed that MPO in diabetic nephropathy group was positively correlated with HbA1c， FBG， Cr， BUN， UA and urinary microalbumin （P<0.05）. Multiple stepwise regression analysis showed that HbA1c， FBG and urinary microalbumin were the main influencing factors of MPO （P<0.05）. Conclusion： MPO is highly expressed in patients with diabetic nephropathy， which is correlated with metabolic indicators such as blood glucose and renal function， and may be involved in the occurrence and development of diabetic nephropathy.

[Key words] Myeloperoxidase Diabetic nephropathy Urinary microalbumin

First-author’s address： Dalian Third People’s Hospital， Dalian 116000， China

doi：10.3969/j.issn.1674-4985.2021.25.041

糖尿病是一组以高血糖为特征的代谢性疾病，糖尿病肾病是最多见的糖尿病微血管病变之一，是糖尿病患者死亡的主要原因之一[1]。该病以尿蛋白的排泄增加为主要临床特点，病理表现为细胞外基质增多、肾小球基底膜增厚、肾小球硬化、间质纤维化和足细胞损伤[2]。该病的具体发病机制还不明确，不过微炎症状态及氧化应激在该病的发生及发展中扮演重要角色。特别是在机体长期处于胰岛素抵抗状态下，肾小管钠水重吸收增加，肾小球处于高灌注、高滤过、高压力状态，可加重肾血管损伤[3]。……