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目的探讨1型糖尿病(T1DM)患者尿中微量免疫球蛋白M(Ig M)水平的变化及意义。方法随访观察常规诊疗的89例T1DM患者,定期测定尿液微量球蛋白Ig M的含量,统计分析其Ig M的水平与心血管事件死亡率和进展为终末期肾病(ESRD)的关系。结果观察病例中,有8例死于心血管事件,6例ESRD,其Ig M含量均明显高于无心血管事件和保存部分肾功能的1型糖尿病患者(P<0.01)。尿微量球蛋白蛋白含量增加,心血管事件死亡率和发展到ESRD的相对危险度(RR)分别是4.9和7.8。结论 1型糖尿病患者尿中Ig M的排泄增加和心血管事件病死率或ESRD密切相关,高含量的尿Ig M预示患者心血管死亡和发展到ESRD的风险增大,早期测定尿Ig M,筛查并进行针对性的治疗对1型糖尿病心血管事件的防治和提高患者的生活质量及预后有积极意义。
Objective To investigate the changes and significance of urinary microimmunoglobulin M (IgM) levels in patients with type 1 diabetes mellitus (T1DM). Methods Regular follow-up of 89 patients with T1DM was performed. The levels of urine microglobulin Ig M were measured regularly. The relationship between IgM levels and cardiovascular mortality and progression to end-stage renal disease (ESRD) was analyzed. Results In the observed cases, 8 cases died of cardiovascular events and 6 cases of ESRD. The IgM levels were significantly higher in patients with type 1 diabetes without cardiovascular events and with preserved renal function (P <0.01). Increased urinary globulin protein levels, cardiovascular events and the relative risk of developing ESRD (RR) were 4.9 and 7.8, respectively. Conclusions The excretion of urinary IgM in patients with type 1 diabetes mellitus is closely related to cardiovascular event mortality or ESRD. High urinary IgM levels predict an increased risk of cardiovascular death and progression to ESRD. Urine Ig M, Check and targeted treatment of type 1 diabetes, prevention and treatment of cardiovascular events and improve the quality of life and prognosis of patients with positive significance.