Urine LAP, PCX And Diabetic Nephropathy Relationship Between Stage And Syndromes

As a diabetic microvascular complications in DM, the incidence increased year by year, once early diabetic nephropathy develop into clinical diabetic nephropathy stage, the condition will be irreversible, and eventually developed into ESRD. Observe some early diabetic patient’s condition is more stable, long-term maintenance of microalbuminuria, but some patients can quickly develop into clinical stage of DN, has important implications for patients with early stage disease and diabetic nephropathy assessed. Clinical urinary podocyte Podocalyxin function is to assess the importance markers, urine LAP is important to assess renal tubular filtration markers can assess the extent of damage to kidney function. Exploration of early diabetic nephropathy and diabetic nephropathy clinical syndrome characteristics and variability trends, and the relationship between stage and urinary PCX/LAP and DN syndromes, to assess progress in predicting DN affection preliminary studyPurpose:Analysis and comparise the early diabetic nephropathy, diabetic nephropathy clinical TCM syndrome characteristics and laws of difference between DM;Explore the relationships between glomerular podocyte PCXs tubular LAP and stages of diabetic nephropathy and the TCM syndromes, for the clinical assessment of early diabetic nephropathy risk of progression of diabetic nephropathy in a preliminary studyMethod:Collect from August2012to January2014period, clinics and wards,patients who diagnosed of the early diabetic nephropathy, clinical stage diabetic nephropathy, DM in patients with non-general data, clinical data, TCM symptoms and syndromes collect judgment; urine specimens from blood samples, in addition to diabetic nephropathy testing, the specimens collected collectively Elisa assay of urinary PCX, LAP level. Aggregated data, using SPSS statistical software community in general patient information, data syndromes descriptive analysis Three groups of patients with laboratory indicators, including urinary PCX, LAP values for independent samples with normal distribution characteristics t test explore urinary PCX using correlation analysis, the relationship between LAP/PCX and stage,TCM syndromes.Results:1. Diabetic nephropathy syndrome characteristics:Overall,Qi-Yin Deficiency type, damp-heat-stasis transimpedance type is multiple. Qi-Yin deficiency syndrome is the highest frequency, followed by yang qi deficiency in the spleen and kidney,Qi-Yang deficiency, Yin-Yang deficiency; Blood stasis syndrome is the first, followed by the damp-heat syndromes, phlegm-damp syndrome followed.Simply diabetes mellitus yindeficiency syndrome have swelter,damp-heat syndromes is the highest frequency; early diabetic nephropathy Qi-Yin Deficiency type frequency gradually increased, blood stasis syndrome, began to increase the frequency of hot and humid syndrome clinical stage of diabetic nephropathy common syndromes Yang appeared to increase the proportion of water retention syndromes, while damp-heat syndromes, blood stasis syndrome, the situation of water retention significantly increase over the previous two periods.2. The detection of urinary podocytes PCX:urinary PCX levels of clinical diabetic nephropathy in patients with diabetic nephropathy earlier lower (P <0.05); urinary PCX levels in early diabetic nephropathy group than simple diabetic patients group is lower (P<0.01); urinary PCX level and urinary microalbuminuria levels were negatively correlated3. Detection of urinary LAP:urinary LAP levels of clinical diabetic nephropathy group compared with early diabetic nephropathy group is significantly higher (P <0.05); urinary LAP levels in patients with early diabetic nephropathy has increased compared with DM group (P<0.01); urine LAP levels and urinary microalbuminuria levels were positively correlated (P<0.05).4. Urine LAP, PCX and DN staging relevance:Urine LAP and DN staging positively correlated (Spearman coefficient:0.505, P=0.00), urinary PCX and DN installments negative correlation (Spearman coefficient:0.557, P=0.01)5. Relationship between urinary LAP, PCX and different syndromes:Urinary PCX in Qi deficiency in spleen and kidney is higher than Yang-qi deficiency group(P=0.08);Qi-Yin deficiency group was higher than Qi-Yang deficiency group (P=0.014), there were no significant difference in other syndromes groups;Urinary LAP levels in Qi deficiency of spleen and kidney group was higher than Qi-Yang deficiency group (P=0.013),Qi-Yin deficiency group (P=0.011), there were no significant difference in other groups.Conclusion:1. Syndrome characteristics:Overall,Qi-Yin Deficiency type, damp-heat-stasis transimpedance type is multiple. Qi-Yin deficiency syndrome is the highest frequency, followed by yang qi deficiency in the spleen and kidney,Qi-Yang deficiency, Yin-Yang deficiency; Blood stasis syndrome is the first, followed by the damp-heat syndromes, phlegm-damp syndrome followed.Simply diabetes mellitus yindeficiency syndrome have swelter,damp-heat syndromes is the highest frequency; early diabetic nephropathy Qi-Yin Deficiency type frequency gradually increased, blood stasis syndrome, began to increase the frequency of hot and humid syndrome; clinical stage of diabetic nephropathy common syndromes Yang appeared to increase the proportion of water retention syndromes, while damp-heat syndromes, blood stasis syndrome, the situation of water retention significantly increase over the previous two periods2. Clinical diabetic nephropathy uric acid, creatinine levels is higher than the early diabetic nephropathy and DM group;3. Levels of clinical diabetic nephropathy urinary LAP was significantly higher compared with early diabetic nephropathy,and positive correlation with microalbuminuria; Levels of clinical diabetic nephropathy urinary PCX was lower compared with early diabetic nephropathy and diabetic mellitus,and negatively correlation with microalbuminuria levels4. Urine LAP and DN staging positively correlated, urinary PCX and DN installments negative correlation4. Urinary PCX in Qi deficiency in spleen and kidney is higher than Yang-qi deficiency group;Qi-Yin deficiency group was higher than Qi-Yang deficiency group, there were no significant difference in other syndromes groups;Urinary LAP levels in Qi deficiency of spleen and kidney group was higher than Qi-Yang deficiency group,Qi-Yin deficiency group, there were no significant difference in other groups.