中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (06): 309-312.doi: 10.3969/j.issn.1671-4091.2013.06.00

• 临床研究 • 上一篇    下一篇

尿血管紧张素原在不伴高血压的糖尿病患者肾损害中的意义

庄震1,白琼2,阿拉塔3,史均宝4,郑丹侠4,王悦3   

  1. 1. 北京大学第三医院第三医院肾内科
    2. 北京大学第三医院肾脏内科
    3. 北京大学第三医院肾内科
    4. 北京大学第三医院
  • 收稿日期:2013-03-27 修回日期:2013-04-11 出版日期:2013-06-12 发布日期:2013-07-01
  • 通讯作者: 王悦 bjwangyue@sina.com E-mail:bjwangyue@sina.com

The value of urinary angiotensinogen in renal function in those diabetic patients who without hypertension

  • Received:2013-03-27 Revised:2013-04-11 Online:2013-06-12 Published:2013-07-01
  • Contact: Yue WANG E-mail:bjwangyue@sina.com

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摘要： 摘要：目的：探讨尿血管紧张素原(urinary angiotensinogen，UAGT)在不伴高血压的糖尿病患者肾损害中的意义。方法：单中心横断面研究，102例不伴高血压、未服用RAS阻断剂的糖尿病患者，根据尿白蛋白/肌酐（UALB/Cr）分为尿蛋白阴性组、微量蛋白尿组和大量蛋白尿组，18例健康人作为对照组，收集人口学资料、生化指标，ELISA法检测UAGT。结果：与健康对照组相比，尿蛋白阴性组患者尿血管紧张素原/肌酐(UAGT/Cr)即显著升高（p<0.001），伴随舒张压显著升高和eGFR显著降低（p<0.01），大量蛋白尿组患者这种差异进一步明显，相关分析显示UAGT/Cr与舒张压、UALB/Cr独立相关（p<0.01），回归分析显示糖尿病患者UAGT是eGFR降低独立的危险因素。结论：本研究发现尿AGT在不伴高血压且尿蛋白阴性的糖尿病患者即开始升高，在糖尿病肾病患者进一步升高，且可能与肾损害进展相关。尿AGT有可能成为预测糖尿病患者肾损害的早期指标。

关键词: 糖尿病, 尿蛋白, 尿血管紧张素原

Abstract: Abstract:Objective: To demonstrate the value of urinary angiotensinogen (UAGT) in renal function in those diabetic patients who without hypertension. Methods: Single centre and cross section study. 102 DM Patients who were hospitalized in Peking University third Hospital from September 2012 to December 2012，had not received ACEI or ARB treatment. Desided by UALB-creatinine ratio (UALB/Cr) devided the patients into three groups: urine protein negative group, microalbuminuria group, macroalbuminuric group. And 18 health people selected to be the control group. To recorded patients’ gender, age, blood pressure, renal function, urinary protein and measured angiotensinogen by ELISA. Results: UAGT–creatinine ratio (UAGT/Cr) UAGT/Cr was significant raised(p < 0.001) in urine protein negative DM group than the control group. At the same time with the diastolic blood pressure significant raised and eGFR significant decreased. (p<0.01). This tendency was more obviously in macroalbuminuric DM group. The result of correlation analysis indicated that UAGT/Cr was the single factor with diastolic blood pressure and UALB/Cr（p<0.01）. Regression analysis indicated that the UAGT was the negative factor for eGFR in DM patients. Conclusion: These data indicate that UAGT was increased in urine protein negative DM patients who without hypertension, and more increased in diabetic nephropathy. The elevator of UAGT maybe correlated with the progress of damage of renal function in diabetic nephropathy patients. The UAGT may to be a marker for prognosis renal damage in diabetic patients.

Key words: Diabetes mellitus, urinary protein, urinary Angiotensinogen