糖化血清白蛋白(glycated albumin,GA)是葡萄糖与血清白蛋白发生非酶促糖基化反应的产物,因蛋白在体内的半衰期较短,17～19d,故GA可反映近2～3周血糖控制的总体水平,临床上主要用于评价糖尿病患者短期糖代谢控制的情况,并指导治疗方案的调整[1].现拟对GA的检测方法、参考范围及其与糖尿病慢性并发症的研究进展进行综述.

Objective: To investigate the relationship between glycated albumin levels and early diabetic nephropathy in patients with type 2 diabetes mellitus.Methods: From January 2012 to June 2012,100 patients with type 2 diabetes mellitus in our hospital were enrolled in the study.We used liquid enzymatic to detect glycated albumin,and compare with 100 cases of non-diabetic nephropathy as the control group.Results: Glycated albumin in diabetic nephropathy group was higher than that in non-diabetic nephropathy group,there were statisti-cally significant differences on glycated albumin among the 2 groups(P0.05).Logistic regression showed that glycated albumin was an independent risk factor impacting on the incidence of diabetic nephropathy and the severity of the disease.Conclusion: Glycated albumin is an independent risk factor impacting in patients with type 2 diabetes mellitus diabetic nephropathy,and plays an important role in the pathogenesis of diabetic nephropathy.

<正>流行病学资料表明,全球糖尿病患者总人数已超过2.4亿。据世界卫生组织(WHO)调查资料证实,糖尿病患者的年增长率达10%左右。中国是全球糖尿患者数最多的国家之一,日前1项调查表明中国糖尿病患病人数已跃居世界第2位[1]。糖尿病控制和并发症试验(DCCT)和英国前瞻性糖尿病研究(UKPDS)表明血糖水平和微血管并发症、大血管并

<正>IgA肾病特征性的表现是IgA及IgG免疫复合物(ICs)弥漫性沉积伴肾小球系膜细胞增生。IgA肾病是世界范围内最常见的原发性肾小球肾炎,最常见的临床表现是镜下血尿伴不同程度的蛋白尿。虽然IgA肾病是慢性进展性疾病,但约25%～50%的患者在确诊后25年内发展为终末期肾病(ESRD)。

Objective: To make the presymptomatic diagnose on the Hans in Heilongjiang province with the microsatellite DNA makers tightly linked with PKD1gene.Methods: The microsatellite DNA makers tightly linked to PKD1 gene were amplified by PCR.Polyacrylamidegel electrophoresis(PAGE),silver staining and Gene linkage analysis were performed.Results: One individual from strip 1 was diagnosed as PKD1 mutation carrier who was in the pre-stage of cyst.Conclusion: Early diagnosis with united-application of mul-ti-microsatellite DNA makers are active,quick and accurate after linked analysis

Objectve To investigate the association between insertion/deletion (I/D) polymorphism of angiotensin converting enzyme (ACE) gene and autosomal dominant polycystic kidney disease (ADPKD). Methods Polymorphism of ACE gene was analyzed by polymease chain reavtion (PCR) in 103 ADPKD patients and 16 ADPKD family constellations including 35 patients and 30 non-ill people. Clinical data were collected and age of onset, hepatocyst, hypertension, urinary tract infecton, urinary concretion, hematuria were used as the main parameters to analyze the association between ACE gene polymorphism and ADPKD. Results The age of onset in DD genotype was 7.2 years younger than that in DI genotype [(31.90±11.41) vs (39.10±10.08) years, P<0.05] and was 14.25 years younger than that in Ⅱ gene type [(31.90±11.41) vs(46.15±14.74) years, P<0.05]. The age of onset in I/D genotype was 7.05 years younger than that in Ⅱ genotype [(39.10±10.08) vs (46.15±14.74) years, P<0.05]. There were significance differences of main clinical symptoms (hypertension, hematuria and urinary tract infection) among three genotype groups. In 11 family constellations, ACE gene polymorphism presented genetic linkage, but without significant difference (P>0.05); the genotype distribution was not significantly different between ADPKD and non-ill people (P>0.05), as well as between man and woman (P>0.05); the DD genotype frequency was significantly higher in ADPKD patients with chronic renal failure (P<0.05). Conclusions The age of onset in DD gentype is the youngest among three groups. The incidence of hypertension and hematuria in DI genotype is the highest. The ACE gene polymorphism in ADPKD family constellation does not provide diagnosis information. The ACE gene I/D polymorphism may not contribute to ADPKD. The DD genotype of ACE may be a risk factor of renal failure in the ADPKD.

目的 探讨同型半胱氨酸(Hcy)及其代谢因素与肾病综合征(NS)的关系.方法 选取40例肾病综合征患者为实验组,40名年龄、性别相匹配的健康人为对照组,比较两组间Hcy、叶酸(FA)、维生素B6(VB6)、维生素B12(VB12)、血脂、凝血及肾功能的异同,并分析实验组Hcy水平与其代谢因素的关系.结果 (1)两组Hcy、FA、VB6、VB12、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)和低密度脂蛋白(LDL)等比较有显著性差异(P<0.01),实验组血脂及凝血机制显著异常;(2)Hcy与APTT、FA、VB6、VB12水平呈负相关,与FIB水平呈正相关,其中VB6对Hcy影响最大.结论 Hcy及其代谢因素与NS密切相关,Hcy与APTT、FA、VB6、VB12水平呈负相关,与FIB水平呈正相关,其中VB6对Hcy影响最大.

同型半胱氨酸(Hcy)是非蛋白成分含硫氨基酸,蛋氨酸(Met)转甲基化中间代谢产物,体内不能合成.血液中总同型半胱氨酸(tHcy)70.%～90%与蛋白结合存在,其余为游离和氧化形式.

Objective To investigate the relationship between the microinflammatory state and morbidity of cardiovascular disease(CVD) in end-stage renal disease(ESRD) by analyzing the relationship between the levels of CRP,Lip(a) and soon indexes in patients with ESRD.Methods Levels of CRP,Lip(a),Fib,Alb,Scr,TC,TG in patients' blood with ESRD and in control group were measured,and the level of Ccr was measured meanwhile.The difference of above-motioned indexes between patients with ESRD and healthy control group was analyzed,and analyzed the relationship between CRP,Lip(a) and Ccr as well as between their levels and morbidity of CVD in ESRD.Results The difference was significant between group in patients with ESRD and control group by the indexes of CRP,Lip(a),Fib,Alb,Scr and soon;the relationship between CRP and Lip(a),Scr,Ccr,HGB was related obviously;the relationship between CRP,Lip(a),Ccr and morbidity of CVD was related significantly.Conclusion In patients with ESRD,the level of CRP is increasing when the Ccr is decreasing significantly,and the relationship between CRP,Lip(a),Ccr and morbidity of CVD in ESRD is significant.

Objective To study the relationship of factors correlated with hypercoagulable state in patients with nephrotic syndrome.Methods 60 patients with nephrotic syndrome(nephrotic group) and 40 healthy(control group) were chosen.Serum protein C(PC),blood routine,albumin,lipid,partial indexes of coagulation and fibrinolysis,BUN,Cr and proteinuria in 24 hours were tested.Results The level of blood TCH,TG,LDL,PC,and proteinuria in 24h and BUN in NS group were higher than those in control(P0.01);and the level of Hct,Fg,Hb,RBC,PLT,PT,PT-INR,TT were different between the two groups(P0.01).PC was correlated with TCH,Fg,Hct,RBC,Hb positively(each P0.01,P0.05)and with blood albumin negatively(P0.01);urine albumin has a positive correlation with TCH,Hct,APTT,Fg,PT and PT-INR(P0.01,P(0.05),respectively) and negative with blood albumin(P0.05).Conclusion Hypercoagulability in patients with NS was affected by such factors as secondary hyperlipidemia,hypercoagulable function caused by actived coagulable system,thrombocytosis,blood concentration and so on.

Objective To study the relationship between fibrinogen(Fbg),abnormal lipid and abnormal protein metabolism in adult with primary nephrotic syndrome(PNS).Methods Fbg,lipid parameters and proteinuria in 24 hours,albumin(ALB) parameters in blood were determined in 63 adult with PNS and relationship between them was observed.Sodium dodecylsuphate gel electropheresis(SDS-PAGE) was used to determine proteinuria types.And difference in every parameters was observed between selectivity proteinuria and non-selectivity proteinuria.Results In group of selectivity proteinuria,parameters in all of Fbg,triglyceride(TG),total cholesterol(T-Ch) and low-density lipoprotein(LDL) increased in adult with PNS.The relationship between Fbg,T-Ch,LDL and proteinuria in 24 hours was posited correlated;the relationship between Fbg,T-Ch,LDL and ALB in blood was negative correlated;and they had reached significant degree in statistics.But the relationship between TG and proteinuria in 24 hours was positive correlated and had reached significant degree in statistics;the relationship between TG and ALB in blood was negative correlated and had not reached significant degree in statistics.In group of non-selectivity proteinuria,parameters in all of Fbg,TG,T-Ch and LDL did not increase obviously in adult with PNS,and had not reached significant degree in statistics.Conclusion Proteinuria of medium molecule is main causes of increasing of Fbg,TG,T-Ch and LDL in adult with PNS.Fbg and hyperlipoproteinemia are closely related to proteinuria and ALB in blood.

Objective To investigate the relationship between insertion/deletion(I/D) polymorphism of angiotension converting enzyme(ACE) gene and autosomal dominant polycystic kidney disease(ADPKD).Methods Polymerase chain reaction(PCR) was used to determine the ACE gene polymorphism in 62 patients with ADPKD and 96 healthy subjects as controls.Results The genotype distribution was not significantly different between ADPKD and normal controls.The DD genotype frequency was significantly higher in ADPKD patients of chronic renal failure.Conclusion The ACE gene I/D polymorphism may not contribute to the happen of ADPKD;The DD genotype of ACE may be a risk marker for the ADPKD to the renal failure stage.

自然杀伤细胞(Natural Killer Cell,NK细胞)做为体内重要的淋巴细胞亚群,通过释放细胞因子参与体内免疫调节,在对病毒、肿瘤等免疫防御机制中起着重要作用.有研究表明,慢性肾衰竭患者NK细胞活性下降,但其下降机制及影响因素有哪些,报道并不多.本文通过对慢性肾炎患者NK细胞活性,红细胞免疫功能的观察,初步探讨红细胞对NK细胞活性的影响机制,现报告如下.

我们自1998年5月～2000年2月应用钙三醇注射剂治疗慢性肾功能不全(CRF)并继发性甲状旁腺功能亢进(SHPT)病人30例,临床收到了较好的效果.现报道如下.

Objective To investigate the relationship between serum level of intactparathy roid hormone(iPTH) and creatinine,urea nitrogen in chronic renal foilure(CRF).Methods We tested the serum levels of iPTH, creatinine and urea nitrogen of 30 patients with CRF. Results There was a direct correlation between the serum concentrations of iPTH and creatinine (rs=0.430923) and urea nitrogen (rs=0.512347). Conclusion There is relationship between the serum iPTH level and the degree of CRF.