糖化血红蛋白对糖尿病肾病早期患者纤溶酶原激活物抑制物1的影响

目的探讨糖化血红蛋白（GHbA1c）对糖尿病肾病（ON）早期患者组织型纤溶酶原激活物（t-PA）以及纤溶酶原激活物抑制物-1（PAI-1）活性的影响。方法2004年4月至2005年5月收治DN早期患者90例。根据GHbA1c水平分为3组，每组各30例。A组GHbA1c〈7％，B组GHbA1c7％-9％，c组GHbA1c〉9％，另选择健康体检者30例作为对照组。所有人选者在清晨空腹抽血测定GHbA1c、t-PA、PAI-1。结果与对照组比较，DN各组GHbA1c、t-PA、PAI-1差异均有统计学意义（P〈0．05或〈0．01），其中t-PA活性下降，而PAI-1活性上升。C组与A组比较t-PA活性下降分别为（0．14±0．06）、（0．28±0．11）U/ml]，PAI-1活性上升分别为（3．25±1．01）、（1．90±1．09）I／ml]，差异均有统计学意义（P〈0．05）；而B组与A组比较t-PA活性有下降趋势，PAI-1活性有上升趋势，但差异均无统计学意义（P〉0．05）。结论DN早期患者体内存在着纤溶系统的失衡，持续高血糖状态进一步破坏纤溶系统，严格控制GHbA1c达标是延缓糖尿病及其并发症发生和发展的重要因素之一。

The effect of glycosylated hemoglobin on serum level of plasminogen activator inhibitor-1 in patients with early diabetic nephropathy

Objective To investigate the effect of glycosylated hemoglobin（GHbA1c） on tissue-type plasminogen activator （t-PA）and level of serum plasminogen activator inhibitor-1 （PAI-1） in patients with early diabetic nephropathy （DN）. Method Ninety patients with early DN from April 2004 to May 2005 were divided into 3 groups according to the level of GHbA1c, which was respectively less than 7 % （group A ）, between 7% and 9% （group B ）, and more than 9% （group C ）. Thirty healthy adults were chosen as control group. The levels of serum GHbA1c, t-PA and PAI-1 were detected on empty stomach in the morning. Results The level of serum t-PA was lower, the activity of PAI-1 was higher in groups of DN than those in control group （P〈 0.05 or 〈 0.01 ）, and those were changed with the level of GHbA1c. There were significant differences between group C and group At-PA： （0.14 ± 0.06）, （0.28 ± 0.11 ） U/ml; PAI-1 （3.25 ± 1.01 ）, （ 1.90 ± 1.09） U/ml ] （P 〈 0.05 ）. Conclusions The fibrinolytie system exists unbalance in patients with early DN. Continuous hyperglycemia in patients with early DN make unbalanced fibrinolytic system more serious. Controlling the level of GHbA1c strictly can play an important role in delaying DN progress.