D-二聚体、纤维蛋白原及胱抑素C与2型糖尿病肾病的关系

目的：探讨D-二聚体（ DD）、纤维蛋白原（ Fib）及胱抑素C（ CysC）水平与2型糖尿病肾病的关系。方法选择2012年1月-2013年12月在该院内分泌科住院的2型糖尿病患者185例，健康体检者47例为对照组（ NC组）。测定其空腹DD、Fib、CysC水平，并按照24 h尿白蛋白排泄率（ UAER）将糖尿病患者分为：正常蛋白尿组（ NA组，UAER＜30 mg· d-1）108例、微量蛋白尿组（MA组，UAER 30～300 mg· d-1）51例、临床蛋白尿组（CP组，UAER ＞300 mg· d-1）26例。观察DD、Fib、CysC与糖尿病肾病之间的关系。结果 MA组和CP组DD、FIB、CysC水平均显著高于NC组及NA组，差异具有统计学意义（均P＜0．05），CP组与MA组相比亦明显升高（均P＜0．05）；MA组和CP组DD、CysC阳性率显著高于NA组（均P＜0．05）。直线相关分析显示DD、FIB和CysC与UAER均呈正相关（r分别为0．380，0．480，0．819，P均＜0．05）结论2型糖尿病患者处于血栓前状态和继发性纤溶亢进，糖尿病肾病患者尤为明显；DD、FIB和CysC水平与糖尿病肾病的发生、发展密切相关。

Association between DD,Fib,CysC and diabetic nephropathy in type 2 diabetic patients

Objective To evaluate the association between DD ,Fib,CysC and diabetic nephropathy in type 2 diabetic patients .Meth-ods One hundred and eighty-five patients with type 2 diabetes mellitus treated in Endocrinology Department of North Hospital of Huainan Xinhua Medical Group during June 2012 to April 2013 were selected ,and 47 healthy people were used for control group .These patients were classified into three groups according to the urine albumin excretion rate （UAER）including normal albuminuria group （NA group：UAER〈30 mg · d-1 ） , micro albuminuria group （ MA group：UAER 30 ~300 mg · d-1 ） and clinical protein uria group （ CP group：UAER 〉300 m· d-1 ） .Results Nephropathy was found in 78 subjects with albuminuria in 52 and proteinuria in 26 subjects . The levels of DD,FIB and CysC in group MA and group CP were significantly higher than those in the group NC or NA （P〈0.05）;and those in group CP were significantly higher than in group MA （P〈0.05）.Correlation analysis suggested that DD ,FIB and CysC were all positively correlated with UAER（r were 0.380,0.480,0.819 respectively,P 〈0.05）.Conclusions The patients with type 2 dia-betes mellitus are in prethrombotic state and secondary hyperfibrinolysis ,especially those with diabetic nephropathy .FIB,DD and CysC are related to the incidence and the development of diabetic nephropathy .