2型糖尿病肾病患者血D-二聚体、纤维蛋白原、C反应蛋白水平的临床意义

目的探讨联合检测血D-二聚体（DD）、纤维蛋白原（FIB）、C反应蛋白（CRP）水平对2型糖尿病肾病并发症的临床应用价值。方法对已确诊的116例2型糖尿病患者同时检测其清晨空腹血DD、FIB、CRP水平，并同时收集24h尿液进行尿微量白蛋白（MA）测定，按尿白蛋白排泄率（UAER）将糖尿病组分3组：正常蛋白尿组（NA组，UAER〈20μg／min）；微量蛋白尿组（MA组，UAER20～200μg／min）；临床蛋白尿组（cP组，UAER〉200μg/min）。结果2型糖尿病组患者DD、FIB、CRP水平在正常蛋白尿组已升高，与对照组比较，差异有统计学意义（P〈0．05），且随UAER增加而增高，3组之间各指标差异均有统计学意义（P〈0．05），且3项联合检测的阳性率明显高于单项检测。结论联合检测血DD、FIB、CRP水平对糖尿病微血管病的发展及糖尿病。肾病有早期诊断意义。

The clinical significance of D-dimer, fibrinogen and C reactive protein in patients with type 2 diabetes mellitus

Objective To study the clinical application value of simultaneous detection of plasma D-dimer(DD), fibrinogen(FIB) and C reactive protein(CRP) levels in early diabetic nephropathy (DN) patients with type 2 diabetes mellitus. Methods The levels of DD, FIB, CRP and 24 h urine microalbumin (MA) from 116 patients with type 2 diabetes mellitus were detected. These patients were classified into three groups according to the urine albumin excretion rate (UAER) including normal albuminuria group (NA group: UAER<20 μg/min), micro albuminuria group (MA group: UAER 20-200 μg/min ) and clinical protein uria group (CP group: UAER >200 μg/min ). Results Plasma DD, FIB and CRP levels in the NA group of diabetes mellitus patients were higher than those in healthy controls (P<0.05), and they were higher with the increased UAER. The levels of DD, FIB and CRP among NA, MA and CP groups were significantly different(P<0.05). The positive rate of simultaneous detection was higher than that of single detection group. Conclusions The simultaneous determination of DD, FIB and CRP is significiant in the early diagnosis and development of the DN.