中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (53): 10011-10015.doi: 10.3969/j.issn.1673-8225.2011.53.032

• 移植与免疫 transplantation and Immunology • 上一篇    下一篇

不同血糖控制水平糖尿病血液透析患者外周血单个核细胞核因子κB的活性

王景福1，邢恩鸿2，段书众1，张  昆1，郭风玲1，赵亚娟1，胡桂才1   

  1. 承德医学院附属医院，1肾内科；2中心实验室，河北省承德市  067000
  • 收稿日期:2011-07-12 修回日期:2011-09-01 出版日期:2011-12-31 发布日期:2011-12-31
  • 作者简介:王景福★，男，1968年生，河北省承德市人，汉族，2011年毕业于河北医科大学，硕士，副主任医师，主要从事慢性肾脏病的营养及血液净化治疗方面的研究。 wangjingfu1968@sina.com
  • 基金资助:

    承德市科学技术研究与发展计划(自筹经费)项目(201021051)。课题名称：维持性血液透析患者外周血单个核细胞NF-κB活性测定及临床意义研究。

Activity of nuclear factor-kappa B in peripheral blood mononuclear cells of diabetes patients at different levels of blood glucose control with maintenance hemodialysis

Wang Jing-fu1, Xing En-hong2, Duan Shu-zhong1, Zhang Kun1, Guo Feng-ling1, Zhao Ya-juan1, Hu Gui-cai1   

  1. 1Department of Nephrology, 2Central Laboratory, Affiliated Hospital of Chengde Medical College, Chengde  067000, Hebei Province, China
  • Received:2011-07-12 Revised:2011-09-01 Online:2011-12-31 Published:2011-12-31
  • About author:Wang Jing-fu★, Master, Associate chief physician, Department of Nephrology, Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China wangjingfu1968@ sina.com
  • Supported by:

    Scientific Technology Research and Development Program of Chengde City, No.201021051*

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摘要：

背景：核因子κB与蛋白激酶C信号转导通路的异常激活是糖尿病及其并发症发生、发展的中心环节。
目的：观察不同血糖控制水平的糖尿病维持性血液透析患者外周血单个核细胞核因子κB活性，探讨其与糖化血红蛋白、超敏C-反应蛋白及营养状况的关系。
方法：横断面分析行维持性血液透析治疗的慢性肾衰竭尿毒症期71例患者各项指标，将其中糖尿病肾病22例患者分为血糖控制良好组12例、血糖控制不良组10例，余49例非糖尿病肾病患者设为对照组。
结果与结论：①血糖控制不良组患者血清白蛋白、前白蛋白显著低于其他两组；超敏C-反应蛋白水平、核因子κB活性显著高于其他两组。②糖化血红蛋白与核因子κB、超敏C-反应蛋白显著正相关，与血清前白蛋白、白蛋白显著负相关；核因子κB与超敏C-反应蛋白显著正相关，均与血清白蛋白、前白蛋白显著负相关。提示糖尿病肾病透析患者血糖控制越差，核因子κB活性越强，炎症反应越明显，营养不良程度越重。血糖控制欠佳导致的核因子κB异常活化是增强糖尿病维持性血液透析患者炎症反应，加重营养不良的重要原因之一。

关键词: 超敏C-反应蛋白, 血液透析, 糖尿病, 核因子&kappa, B, 营养不良

Abstract:

BACKGROUND: Abnormal activation of nuclear factor-kappa B (NF-κB) and protein kinase C signal transduction pathway is the central link of occurrence and development of diabetes mellitus and related complications.
OBJECTIVE: To investigate the NF-κB activity in peripheral blood mononuclear cells (PBMC) in diabetes patients of different levels of blood glucose control with maintenance hemodialysis and investigate the relationship of NF-κB activity with glycosylated hemoglobin (HbAlc) and high sensitive C reactive protein (hs-CRP) levels and malnutrition.
METHODS: The indices of 71 chronic renal failure uremia patients with maintenance hemodialysis were analyzed through cross-sectional study. Twenty-two diabetic nephropathy patients with maintenance hemodialysis were divided into good control of blood glucose group (n=12) and poor control of blood glucose group (n=10). The other 49 non-diabetic nephropathy patients with maintenance hemodialysis were taken as control group.
RESULTS AND CONCLUSION: The serum albumin and serum prealbumin levels of patients in the poor control of blood glucose group were significantly lower than those in the good control of blood glucose group and non-diabetic nephropathy group.The serum hs-CRP level and NF-κB activity of patients in poor control of blood glucose group were significantly higher than those in the good control of blood glucose group and non-diabetic nephropathy group. HbAlc was positively correlated with serum hs-CRP level and NF-κB activity and was negatively correlated with serum albumin and serum prealbumin. NF-κB activity was positively correlated with hs-CRP levels and was negatively correlated with serum albumin and serum prealbumin. The results suggest that poorer control of blood glucose in diabetic nephropathy patients with maintenance hemodialysis leads to stronger NF-κB activity, more obvious inflammatory reaction and more severe malnutrition. Abnormal activation of NF-κB induced by poor control of blood glucose is one of the main reasons that aggravate inflammatory reaction and malnutrition for diabetes patients with maintenance hemodialysis.

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