The Correlation Studies Between Hs-CRP、VEGF And Renal Artery Blood Flow Velocity And Resistance Index In Early Stage Diabetic Nephropathy

Objective: To explore the correlation between serum hs-CRP, VEGF and renal artery blood flow velocityand resistance index in early stage diabetic nephropathy,in order to provide clinical reference value forearly diagnosis and intervention therapy of DN.Methods: we selected60T2DM patients in endocrinology department of the first affiliated hospital,Shi HeZi University from March to August2013(all conform to the world health organization (WHO) in1999diabetes diagnosis and classification standard), then randomly divided them into two groups according toUrinary Albumin Excretion Rate(UAER):I group:30cases of diabetes alone group (UAER <30mg/d); Ⅱgroups: microalbuminuria group30cases (30mg/d or less UAER <300mg/d). Meanwhile, selected30cases the same check-up crowd, except for diabetes, high blood pressure, kidney primary disease as controlgroup(NC group). To return the serum, urine specimen, Detection of serum hs CRP, VEGF, blood sugar,blood lipid, renal function and UAER, And the crowd is bilateral renal artery doppler colour to exceedexamination, to observe the renal blood perfusion, records of kidney MRA, SRA, IRA PSV, EDV and RI,relevant data for statistical analysis.Results:1. General information:Three groups in age, sex, BMI, blood pressure, etc. There was nosignificant difference (P>0.05), comparable; Ⅱ group and I set the course and the difference wasstatistically significant (P <0.05).2.Compared with The hs-CRP, VEGF and biochemical indicators: Threegroups in TC, HDL-C, LDL-C and other aspects of the relative ratio of the difference was not statisticallysignificant (P>0.05). Ⅱ group hs-CRP, VEGF, FBG, TG, BUN, SCr levels were significantly higher in the(NC group), the difference was statistically significant (P <0.01). Ⅱ group in hs-CRP, VEGF, TG, BUN,SCr and group Ⅰ than the relative differencewas statistically significant (P <0.05, P <0.01), but the extentof the FBG Ⅰ group, no significant difference (P Ⅱ group>0.05).3.Comparison of renal artery bloodflow parameters at all levels: MRA, SRA, PSV values IRA from NC group, Ⅰ group trends,Ⅱgroup wasgradually reduced, trends EDV value is gradually reduced to lower EDV obvious; RI values the trend isgradually increasing; Ⅰgroup compared with the NC group, PSV levels of renal artery branches, EDV, RIdifference was not statistically significant (P>0.05); Ⅱgroup compared with the NC group, the renalartery levels PSV branch, EDV were lower than those in NC, RI higher than NC group, the difference wasstatistically significant (P <0.05); compared with group Ⅰ, Ⅱ levels of renal artery PSV,EDV decreased,RI rose significantly, the difference was statistically significant (P <0.05, P <0.01).4. The hs-CRP、VEGFand correlation analysis of renal blood flow parameters: Hs-CRP and MRA, SRA, IRA PSV value nosignificant correlation (P>0.05), With MRA, SRA, IRA EDV value showed a negative correlation (r=0.447,0.462,0.472, P<0.01), and the RI value of MRA, SRA, IRA were positively correlated (r=0.603,0.611,0.632, P<0.01); VEGF and MRA, SRA, IRA PSV value showed a negative correlation (r=0.261,0.299,0.303, P<0.05~0.01), With MRA, SRA, IRA EDV value showed a negative correlation (r=0.454,0.481,0.546, P<0.01), and the RI value of MRA, SRA, IRA were positively correlated (r=0.645,0.676,0.718,P<0.01).And the positive correlation between VEGF and hs-CRP (r=0.813, P<0.01). Conclusion:1. DN patients with serum hs-CRP concentration higher than the general population, DN existsinflammatory reaction condition.2. DN patients serum hs-CRP and VEGF levels higher than the purediabetes, and both increase with the rising of UAER, prompt both associated with the occurrence anddevelopment of DN.3. Serum hs-CRP and VEGF are associated with renal artery blood flow velocity andresistance index, serum hs-CRP and VEGF can affect the renal hemodynamic changes；And the serumVEGF concentration and hs-CRP concentration was significantly positively correlated,Tip VEGF possiblythrough inflammatory mechanisms involved in DN renal microvascular disease, and thus presumablyserum hs-CRP and VEGF may be the DN renal microvascular disease early predictors.