血浆活化蛋白C与2型糖尿病肾病患者动脉粥样硬化的相关性

目的：探讨活化蛋白C（APC）与2型糖尿病肾病（DKD）患者动脉粥样硬化的关系。方法：ELISA方法检测41例2型糖尿病肾病患者和27位对照组志愿者的血浆APC水平,颈动脉超声测量颈动脉内中膜厚度（IMT）作为全身动脉粥样硬化的衡量指标。结果：与对照组相比,2型糖尿病肾病患者的血浆APC水平显著性降低[（10389.0±1801.9）vs（6693.3±1790.5）ng/ml,P〈0.001]。单因素相关分析显示,2型糖尿病肾病非透析患者的颈动脉IMT与血浆APC水平（r=-0.511,P〈0.01）负相关。多元逐步线性回归分析显示APC是平均颈动脉IMT的显著性相关因素（β=-0.492,P〈0.01）,且24h尿白蛋白排泄率（β=-0.719,P〈0.05）、血红蛋白（β=0.522,P〈0.05）是血浆APC水平的显著性相关因素。结论：APC的减少可能与2型糖尿病肾病患者的动脉粥样硬化相关,并可能在其动脉粥样硬化的病理过程中发挥作用。

Association of Decreased Activated Protein C and Atherosclerosis in Patients with Type 2 Diabetic Nephropathy

Objective：To explore the relationship between the degree of atherosclerosis as measured by the intima-media thickness （IMT） of carotid artery and APC generation in type 2 diabetic nephropathy （DN） patients.Methods：Forty-one patients with type 2 DN and twenty-seven control subjects were recruited in the trial.Plasma APC levels were tested by ELISA.The mean IMT of carotid artery was measured by ultrasonography.Results：Plasma APC levels were significantly lower in patients type 2 DKD than in control subjects[（6 693.3±1 790.5）ng/ml vs （10 389.0±1 801.9）ng/ml,P0.01].Univariate analysis showed a significant and inverse correlation between plasma APC levels and mean IMT （r=-0.511,P0.01）,and multivariate regression analysis confirmed the independent correlation（β=-0.492,P0.01）.Moreover,urinary albumin excretion rate （UAER）（β=-0.719,P0.01） and hemoglobin level （β=0.522,P0.05） were independent risk factors of plasma APC reduction.Conclusion：Decreased APC generation may be associated with vascular atherosclerotic changes and play an important role in the pathogenesis of atherosclerosis observed in patients with type 2 DN.