Analysis On Changes And Influencing Factors On Glomerular Charge Barrier Of DN Patients At Different Stages

Purpose: To observe changes and influencing factors on glomerular charge barrier of DN（diabetic nephropathy） patients at different stages in the hope of providing experience basis for the necessity to add charge barrier repairing drugs when treating DN at different stages, and providing basis for blood sugar and blood fat intervention when damages are caused to DN charge barrier.Method: Measure the serum, urine amylopsin and salivary amylase of Group A of the control group, and Group B（diabetes normoalbuminuria group）, Group C（DN stage-III group）, Group D（DN stage-IV group）, and Group E（DN stage–V group） of the observation group with 30 cases for each group respectively, calculate and compare the ratio(C_PAM/ C_SAM) between clearance rate of amylopsin(C_PAM) and that of salivary amylase(C_SAM), in order to evaluate changes to glomerular charge barrier of each group. Measure Hb A1 c, blood sugar and blood fat values of each group, and apply bivariate correlation analysis to study the correlation between C_PAM/ C_SAM value and Hb A1 c, FPG, 2h PG, CH, TG, LDL, for the purpose of providing basis for the blood sugar and blood fat intervention when damages are caused to DN charge barrier.Result: The glomerular charge barrier damage of DN occurred in various stages, especially after III DN.C_PAM/ C_SAM comparison result of each group: differences in the pairwise comparison between Group B, Group C and Group D all have statistical significance（P<0.05）; differences between Group B and Group A, Group D and Group E do not have any statistical significance（P>0.05）. It shows negative correlation between C_PAM/ C_SAM value and TG, CH, Hb A1c（-1<r<0,P<0.05）; it does not show any correlation between C_PAM/ C_SAM value and LDL, FPG, 2h PG（P>0.05）.Conclusion: With the progression of DN disease course, glomerular charge barrier is damaged more and more seriously, its effect to prevent the forming of proteinuria becomes weaker and weaker gradually, and almost all charge barriers are lost at DN stage IV. C_PAM/ C_SAM value of DM patients shows negative correlation with Hb A1 c, the bigger the Hb A1 c value is, the smaller the C_PAM/ C_SAM value will be, the severer the damages to charge barrier will be, and reducing Hb A1 c may delay damages to glomerular charge barrier. C_PAM/ C_SAM value of DM patients shows negative correlation with TG and CH, the bigger the TG and CH values are, the smaller the C_PAM/ C_SAM value will be, the severer the damages to charge barrier will be, and reducing TG and CH may delay damages to glomerular charge barrier. C_PAM/ C_SAM value of DM patients does not have any correlation with FPG or 2h PG, short-term glucose fluctuation may not be the independent risk factor for damages to renal charge barrier, and long-term glucose control is of great significance on preventing damages to DN charge barrier.