联合检查D-二聚体纤维蛋白原和C反应蛋白在2型糖尿病肾病中临床应用价值

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(DN)并发症的临床应用价值.方法 对已确诊的180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24h尿白蛋白排泄率(UAER)将糖尿病组分3组:单纯糖尿病组(SDM组,UAER＜30mg/24h);早期糖尿病肾病组(EDN组,UAER 30～300mg/24h);临床糖尿病肾病组(CDN组,UAER＞300mg/24h).结果 2型糖尿病组患者DD、FIB和CRP水平在单纯糖尿病组已升高,与对照组比较差异有统计学意义(P＜0.01),且随UAER增加而增高,呈正相关.三组之间各指标比较,差异均有统计学意义(P＜0.01).结论 联合检查DD、FIB和CRP水平,可明显提高糖尿病早期肾脏损伤检出率,同时还发现其与糖尿病肾病的发生、发展关系密切.

The value of detecting plasma D-dimer, fibrinogen and C-reactive protein levels type 2 diabetic nephropathy

Objective The combined detection of plasma D - dimer （ DD）, fibrinogen （ FIB）, C - reactive protein （CRP） levels in type 2 diabetic nephropathy in clinical practice. Methods 180 cases that had been diagnosed with type 2 diabetes detected were tested for fasting DD, FIB, CRP level early in the morning, and also 24h urine microalbuminuria （MA） by 24h urinary albumin excretion rate by which patients were divided into 3 groups： DM group （SDM group, UAER 〈 30mg/24h） ; early diabetic nephropathy （EDN group, UAER 30 -300mg/24h） ; clinical diabetic nephropathy （CDN group, UAER 〉 300mg/24h） . Results Type 2 diabetes patients＇DD, FIB and CRP levels increased in DM group significantly, compared with the control group（ P 〈0.01 ） , and UAER increase with higher positive correlation. Among the three groups of indexes, the differences were statistically significant （ P 〈 0.01 ）. Conclusion Combined test of DD, FIB and CRP levels, may improve the detection rate of early diabetic kidney damage, also they are related to the incidence and the development of diabetic nephropathy.