2型糖尿病肾病患者外周血单个核细胞组织因子活性检测的意义

目的探讨2型糖尿病肾病患者外周血单个核细胞组织因子促凝活性（TF-PCA）的改变及其临床意义。方法 63名2型糖尿病患者按照尿白蛋白/肌酐比共分为三组：比值〈30mg/g为正常蛋白尿组（n=22）,30mg/g≤比值〈300mg/g为微量白蛋白尿组（n=26）,比值≥300mg/g为大量白蛋白尿组（n=15）;同时选择21名健康体检者作为对照组。采用一期凝固法测定外周血单个核细胞TF-PCA。常规检测空腹血糖、糖化血红蛋白、超敏CRP（Hs-CRP）、尿酸（UA）、胱抑素C（CYSC）,并进行相关分析。结果糖尿病组外周血TF-PCA随尿蛋白水平升高而升高,同时单个核细胞TF-PCA与空腹血糖、Hs-CRP、UA等呈正相关,相关系数分别为0.419、0.293、0.232（P〈0.05）。结论 2型糖尿病患者外周血单个核细胞TF-PCA明显升高,且与多种因素相关,TF-PCA升高可能与DN的发病机制、病程进展相关。

Tissue factor procoagulant activity of peripheral blood mononuclear cells in patients with diabetic nephropathy

Objective To examine the tissue factor procoagulant activity（TF-PCA） of peripheral blood mononuclear cells in patients with type-2 diabetes mellitus（T2DM） and diabetic nephropathy,and explore the relationship between TF-PCA and the associated parameters.Methods 63 patients with T2DM were divided into three groups according to their urine albumin /creatinine ratio（UACR）：22 cases with normal albuminuria,26 cases with microalbuminuria and 15 cases with macroalbuminuria.The levels of fasting glucose,uric acid（UA）,serum cystatin C（cysc）,glycohemoglobin A1c（HbA1c）,hyper-sensitive CRP（hs-CRP） and the TF-PCA were measured.Results Compared with the control group,TF-PCA in T2DM was significantly increased.TF-PCA was positively correlated with UACR,fasting glucose,UA and hs-CRP.Conclusion TF-PCA of peripheral blood mononuclear cells in patients with T2DM was correlated with several clinical indexes and the level of TF-PCA is implicated in the development and progression of diabetic nephropathy.