| OBJECTIVE DN is a common microvessel complication of DM, in the meanwhile is one of the important reason of leading DM patients to death or disability. Studies had shown that cytokines have an important part in DN's occurrence and development. This investigation aim to find out the relationship between VEGF> ET and DN's occurrence and development, furthermore to find out the relationship between VEGF> ET and TCM's pathogeny and syndrome variation. So the result perhaps may provide a theory of diagnosis and therapy of DN.METHODS 66 patients of DM selected randomly were divided into NDN group(non-DN,n=20),DN3 group(DNIII phase, n=23) DN4 group(DNIV phase, n=22), and according to syndrome differentiation, DN patiens were divided into (qi)yang deficiency of the spleen and kidney, stagnation of phlegm and blood stasis group and both qi and yin, stagnation of blood stasis group. 20 healthy people with no statistic difference with the formers were selected as control group. Serum VEGF and plasm ET were measured by enzyme-linked immunoadsorbent assay, urine ALB by monoclonal, HbAic by immunoassay, and the marker of hemorheology triglyceride cholesterol low-density lipoprotein cholesterol high-density lipoprotein cholesterol were determined.RESULTS (1) HbA1C levels of DN3 group and DN4 group were higher than NDN group (P<0. 05, P<0. 01 = , but there was no difference between DN4 group and DN3 group (P>0. 05 ). (2) Comparing with NDN group, the level of VEGF, ET in DN3group and DN4 group increased significantly (P<0. 01, P<0. 01); comparing with DN3 group, the concentration of VEGF, ET in DN4 group increased significantly (P<0. 01); and VEGF had a positive correlation with Alb (r=0.527), in the same time ET had a positive correlation with Alb (r=0.708). (3) (qi)yang deficiency of the spleen and kidney, stagnation of phlegm and blood stasis group was higher than deficiency of both qi and yin, stagnation of blood stasis group on low-cutting blood viscosity, erythrocyte aggregation index (P<0. 05)>high-cutting blood viscosity (P<0. 01). (4) ET concentration of (qi)yang deficiency of the spleen and kidney,stagnation of phlegm and blood stasis group was higher than deficiency of both qi and yin, stagnation of blood stasis group (P<0. 01), and ET had a positive correlation with low-cutting blood viscosity, high-cutting blood viscosity, erythrocyte aggregation index, plasm viscosity (r=0.823, 0.808, 0.813, 0.745 respectively, P<0. 05). (5) VEGF concentration of (qi)yang deficiency of the spleen and kidney, stagnation of phlegm and blood stasis group were increased significantly compare with deficiency of both qi and yin, stagnation of blood stasis group (P< 0. 05). (6) There was a positive correlation between VEGF and ET (r=0.708, P< 0. 05). (7) According to constituent ratio, (qi)yang deficiency of the spleen and kidney,stagnation of phlegm and blood stasis was fewer than deficiency of both qi and yin,stagnation of blood stasis in DN3 group; but in DN4 group the situation was just contrary.CONCLUSION (1 )Besides blood glucose far from satisfactory, other factors play roles in occurrence and development of DN, the occurrence and development of DN had a closed relation with VEGF, ET concentration. In the same time, VEGF and ET play a interaction role in DN. (2) In TCM phrase, the concentration of ET had a closed relation with blood stasis, the concentration of VEGF had a closed relation with turbin phlegm. Furthermore phlegm and blood stasis could be exchanged. (3) deficiency of both qi and yin,stagnation of blood stasis had a closed relation with DN ealier period(DN III phase), meantime (qi)yang deficiency of the spleen and kidney, stagnation of dampness and blood stasis had a closed relation with DN clinical period(DN IV phase), imply that the typing of TCM and the staging of western medicine(WM) had a relation. VEGF, ETmight be a objective index which could instruct the typing of TCM. |
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