The Study On TACE And Diabetic Nephropathy Proteinuria Level And Its Card-based Correlation

Research background:Tumor Necrosis Factor a converting enzyme(TACE)is a specific metalloproteinase catalytic TNF-alpha Precursor Pyrolysis,on the translation level regulation of inflammatory cytokines,growth factors and even many membrane receptors mature release,promote renal fibrosis.At the same time,TACE is activated in diabetic conditions and is involved in the progression of chronic diabetic complications.Purpose:To analyze the relationship between diabetic nephropathy and the distribution of TCM syndromes through measuring the level of TACE in the patients with type 2 diabetes mellitus and diabetic nephropathy.Method:Collected during the period from March 2016 to January 2017,the Chinese Medicine Hospital of Jiangsu Province outpatient and inpatient meet the inclusion criteria,54 cases of patients with T2DM.According to the level of proteinuria is divided into three groups:11 cases of patients with normal albuminuria(DM),a small amount of protein urine in patients with 16 cases(DN trace group),27 cases of massive proteinuria in patients(DN large group).TCM divided into 42 cases of damp stasis blocking collaterals;12 cases of non-damp stasis blocking collaterals.The basic information were collected(gender,age,height,weight,body mass index,combined diseases),TCM symptoms(symptoms,signs,tongue and pulse),biochemical indexes(ACR,24hrUTP,FBG,urine PBG,blood lipid,CRP,etc.),and calculate the eGFR(reference CKD-EPI 2012-creatinine cystatin C equation)and HOMA-IR(HOMA-IR=Fins*FBG/22.5).The levels of TACE were detected in each group,and the correlation between the expression level and diabetic nephropathy and other biochemical indexes and the relationship between the expression of the blood stasis and dampness obstruction were further analyzed.Results:1.DN group Shiyuzuluo incidence was significantly higher than the DM group(88.37%,36.36%,P<0.01)?.2.The TACE,ACR,UTP and HOMA-IR index of the shiyuzulo group were higher than those in the feishiyuzuluo group(5.01 �2.38,4.45�1.44,P>0.05;2.38�0.76,1.48�0.89,P<0.01;2.09�0.65,2.09�0.65,P>0.05;0.86�0.47,0.51�0.46,P<0.05).3.54 cases of type 2 diabetes patients in the DN group was higher than the DM group(5.09�2.32,4.06�1.45,P>0.05),and with the progress of diabetic nephropathy,TACE level increased gradually in the patients with type 2 diabetes(DM group4.06�1.45,DN trace group 4.57�1.56,DN large group 5.41�2.65,P>0.05).4.In 54 patients with type 2 diabetes mellitus,the TACE value of DM group had no correlation with ACR,UTP,HOMA-IR index,and the TACE value of DN group was positivelycorrelated with ACR,UTP and urine index(r=0.306,P<0.05;r=0.329,P<0.05;r=0.333,P<0.05).5.In 43 patients with diabetic nephropathy,the TACE value of DN group was positively correlated with urinary ACR(r=0.521,P<0.05),and the TACE value of DN group was positively correlated with ACR and UTP(r=0.421,P<0.05;r=0.401,P<0.05).Conclusion:1.The DN Shiyuzuluo incidence was significantly higher than the DM group prompt Shiyuzuluo,it is suggested that the relationship between dampness and blood stasis may be closely related to the development of diabetic nephropathy.2.The level of TACE in shiyuzuluo group was higher than that of feishiyuzuluo group,which indicated that TACE was closely related to dampness and blood stasis syndrome,and could be used as one of the objective indexes of the syndrome.3.With the development of proteinuria in diabetic nephropathy,the level of TACE increased gradually.The level of TACE was positively correlated with urinary ACR,UTP and HOMA-IR,and could be used as a risk factor for diabetic nephropathy.There is a certain reference value for judging the severity of the disease...