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血清miRNA-21与糖尿病肾病不同分期中医证型 及实验室指标的相关性研究*(PDF)

《云南中医学院学报》[ISSN:1000-2723/CN:53-1048/R]

期数:
2018年04期
页码:
35-40
栏目:
临床研究
出版日期:
2019-03-25

文章信息/Info

Title:
Relationship between Serum miRNA-21 and TCM Syndrome Types and Laboratory Indexes in Different Stages of Diabetic Nephropathy
文章编号:
1000 - 2723(2018)04 - 0035 - 06
作者:
苏保林1李敬2汤水福1△陈刚毅1
(1. 广州中医药大学第一附属医院,广东 广州 510405;2. 华南师范大学医院,广东 广州 510631)
Author(s):
SU Baolin1 LI Jing2 TANG Shuifu1 CHEN Gangyi1
(1. The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China; 2. South China Normal University Hospital, Guangzhou 510631, China)
关键词:
血清miRNA-21 糖尿病肾病 中医证型 相关性
Keywords:
serum miRNA-21 diabetic nephropathy TCM syndrome type relativity
分类号:
R259
DOI:
10.19288/j.cnki.issn.1000-2723.2018.04.008
文献标识码:
A
摘要:
目的观察血清miRNA-21与糖尿病肾病(diabetic nephropathy,DN)不同分期中医证型及实验室指标的相关性。方法将符合纳入标准的2型糖尿病(type 2 diabetes mellitus,T2DM)及DN患者60例分为T2DM、DN Ⅲ期、DN Ⅳ期、DN Ⅴ期共4组,每组15人,同时设立健康对照组15人,收集各组四诊资料,进行中医辨证分型;并检测各组血清miRNA-21表达水平及血肌酐(Scr)、尿素氮(BUN)、胱抑素C(CysC)、血清白蛋白(Alb)、胆固醇(CHOL)、甘油三酯(TG)、肾小球滤过率估计值(eGFR)、尿蛋白定量、血液流变学等指标。结果DNⅤ期、DN Ⅳ期、DN Ⅲ期血清miRNA-21明显高于健康组(P<0.05);DN Ⅳ期较DN Ⅲ期增高(P<0.05);T2DM组与健康组无显著性差异(P>0.05),DNⅤ期较DN Ⅳ期明显下降(P<0.05)。中医辨证方面,阴虚燥热证比例最低,气阴两虚证次之(P<0.05);脾肾气虚证及阴阳两虚证比例最高(P<0.05);脾肾气虚证与阴阳两虚证无显著性差异(P>0.05)。血清miRNA-21表达情况,气阴两虚、脾肾气虚及阴阳两虚组均明显升高(P<0.05);其中脾肾气虚组与阴阳两虚组升高更明显(P<0.05);但脾肾气虚组与阴阳两虚组比较差异无统计学意义(P>0.05)。标证中,湿证者为16例,占26.7%,痰证15例,占25%,瘀证为29例,占48.3%,瘀证所占比例最高(P<0.05);瘀证组血清miRNA-21升高更明显(P<0.05);湿证组与痰证组比较,差异无统计学意义(P>0.05)。相关性研究结果显示,血清miRNA-21表达与DN Ⅲ期、DN Ⅳ期患者BUN、Cr、Cysc及血沉K值呈正直线相关,与eGFR呈显著负直线相关;对于DN Ⅴ期,血清miRNA-21仅与血沉K值呈显著正直线相关。结论血清miRNA-21在DN不同分期中表达差异明显,血清miRNA-21与DN患者某些实验室指标之间可能存在一定的相关性。
Abstract:
Objective To observe the correlation between serum miRNA-21 and diabetic nephropathy(DN) in different stages of TCM syndromes and laboratory indexes. Methods Sixty patients with type 2 diabetes mellitus(type 2 diabetes mellitusus, T2DM) and DN were divided into 4 groups, 15 in each group, and 15 healthy people in control group. Collect the data of four diagnoses in each group, and carry out TCM syndrome differentiation and typing. Serum miRNA-21 expression and serum creatinine(Scr), urea nitrogen(BUN), cystatin C(CysC), serum albumin(Alb), cholesterol(CHOL), triglyceride(TG), glomerular filtration rate estimated value(eGFR), urinary protein quantification and blood rheology were checked in each group. Results The level of serum miRNA-21 in DN V stage、DNⅣstage、DNⅢstage was significantly higher than that in normal group(P<0.05); DNⅣstage was higher than DNⅢstage(P<0.05); There was no significant difference between T2DM group and normal group(P>0.05), The level of serum miRNA-21 in DN V stage was significantly lower than that in DN Ⅳ stage(P<0.05). In TCM syndrome differentiation, the proportion of yin deficiency and heat dryness syndrome was the lowest, qi and yin deficiency syndrome was the second(P<0.05), spleen and kidney qi deficiency syndrome and yin and yang deficiency syndrome was the highest(P<0.05), and there was no significant difference between spleen and kidney qi deficiency syndrome and yin and yang deficiency syndrome(P>0.05). The expression of serum miRNA-21 was significantly increased in the deficiency of Qi and Yin, deficiency of spleen and Kidney Qi and deficiency of Yin and Yang(P<0.05), especially in the deficiency of spleen and Kidney Qi and Yin and Yang groups(P<0.05), but there was no significant difference between the deficiency of spleen and Kidney Qi group and that of Yin and Yang deficiency group(P>0.05). There were 16 cases of dampness syndrome(26.7%), 15 cases of phlegm syndrome(25%), 29 cases of blood stasis syndrome(48.3%). The proportion of blood stasis syndrome was the highest(P<0.05), the serum miRNA-21 of blood stasis syndrome group was the highest(P<0.05); There was no significant difference between dampness syndrome group and phlegm syndrome group (P>0.05). The results of correlation study showed that the expression of serum miRNA-21 was positively correlated with BUN、Cr、Cysc and K value of erythrocyte sedimentation rate in patients with DN Ⅲ and DN Ⅳ, and negatively correlated with eGFR; while serum miRNA-21 was only positively correlated with K value of erythrocyte sedimentation rate in DN Ⅴstage. Conclusion The expression of serum miRNA-21 was significantly different in different stages of DN, and there might be some correlation between serum miRNA-21 and some laboratory indexes of DN patients.

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备注/Memo

备注/Memo:
收稿日期: 2018 - 08- 16
*基金项目: 广东省省级科技计划项目(2017A020213033);广东省中医药局项目(20172050)
第一作者简介: 苏保林(1980-),男,同等学力申请博士学位人员,主治医师,从事慢性肾脏病的临床和科研工作。
△通信作者: 汤水福,E-mail:tsf08@126.com
更新日期/Last Update: 2018-10-30