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目的 :探讨糖尿病肾病患者微炎症状态和氧化应激的水平,并分析其影响因素。方法 :选取129例2型糖尿病(T2DM)患者及144例糖尿病肾病(DKD)患者,分为T2DM组和DKD组,比较两组血清炎症标志物超敏C-反应蛋白(hs-CRP)和氧化应激指标丙二醛(MDA)水平、一般临床资料(病程、血压等)和生化指标[胆固醇、甘油三酯、糖化血红蛋白(Hb A1c)等],将两组间存在统计学差异的相关性指标代入多元线性回归方程分析hs-CRP和MDA的影响因素。结果:1DKD患者血清hsCRP和MDA较T2DM组显著增高,差异有统计学意义(P<0.01);2直线相关分析显示hs-CRP及MDA均与DM病程、尿素氮(BUN)、肌酐(Cr)、尿酸(UA)、Hb A1c、24 h尿蛋白定量、同型半胱氨酸(HCY)呈正相关,此外,MDA还与总胆红素、直接胆红素均呈负相关。3多元线性回归分析显示hs-CRP的影响因素是DM病程、UA、Hb A1c、HCY,MDA的影响因素为DM病程、Hb A1c。结论 :DKD患者普遍存在微炎症和氧化应激水平的增高,DM病程、UA、Hb A1c、HCY作为微炎症的影响因素,氧化应激的影响因素为DM病程、Hb A1c,综合控制血糖、尿酸等可以更好地减轻DKD患者的微炎症和氧化应激状态。
Objective: To investigate the status of micro-inflammation and oxidative stress in patients with diabetic nephropathy and to analyze the influencing factors. Methods: 129 patients with type 2 diabetes mellitus (T2DM) and 144 patients with diabetic nephropathy (DKD) were enrolled and divided into two groups: T2DM group and DKD group. Serum inflammatory markers hs-CRP and oxidation There were statistically significant differences between the two groups in the level of malondialdehyde (MDA), general clinical data (course of disease, blood pressure) and biochemical indicators (cholesterol, triglyceride, HbA1c, etc.) Index into the multivariate linear regression equation analysis of hs-CRP and MDA influencing factors. Results: The serum hsCRP and MDA levels in 1DKD patients were significantly higher than those in T2DM patients (P <0.01); 2 The linear correlation analysis showed that hs-CRP and MDA were positively correlated with the duration of DM, BUN and Cr, , Uric acid (UA), Hb A1c, 24 h urinary protein and homocysteine (HCY). In addition, MDA also had a negative correlation with total bilirubin and direct bilirubin. 3 Multiple linear regression analysis showed that the influencing factors of hs-CRP were the course of DM, UA, Hb A1c, HCY and MDA, the course of DM and Hb A1c. CONCLUSIONS: Micro-inflammation and oxidative stress are common in patients with DKD. DM duration, UA, Hb A1c and HCY are the influencing factors of micro-inflammation. The factors of oxidative stress are DM duration, Hb A1c, comprehensive control of blood glucose, uric acid Etc. can better alleviate micro-inflammation and oxidative stress in DKD patients.