论文部分内容阅读
目的探讨2型糖尿病(T2DM)患者血浆PAI-1水平变化及其与尿微量白蛋白(MAU)的相关性,了解PAI-1在2型糖尿病及其血管并发症发病机制中的作用。方法选取60例未经过治疗的初诊T2DM患者(观察组)和30例与T2DM患者临床资料相匹配的正常健康体检者(对照组)为研究对象,并根据MAU检测结果将观察组分为MAU正常亚组(30例)和MAU阳性亚组(30例),按标准方法检测研究对象的血糖(FBG)、胰岛素(FINS)、糖化血红蛋白(HbA1c)、血脂(TC、TG、LDL-C和HDL-C)、血浆PAI-1、MAU等,并应用SPSS11.0统计软件对检测结果进行相应的统计学分析。结果 (1)观察组FBG、HbA1c、TC、TG、LDL-C水平显著高于对照组(P<0.01或P<0.05),但两组HDL-C水平无显著差异(P>0.05),而且观察组两亚组间各指标差异均无统计学意义(P>0.05)。(2)MAU正常亚组FINS水平与对照组差异无统计学意义(P>0.05),但MAU阳性亚组FINS水平显著高于对照组(P<0.05),且观察组两亚组间差异无统计学意义(P>0.05)。(3)观察组HOMA-IR水平显著高于对照组(P<0.05),但观察组两亚组之间差异无统计学意义(P>0.05)。(4)观察组两个亚组血浆PAI-1水平均显著高于对照组(P<0.01),而且MAU阳性亚组血浆PAI-1水平亦显著高于MAU正常亚组(P<0.01)。(5)血浆PAI-1水平与Alb/cr、HOMA-IR、FBG、HbA1c、BMI、TC、TG等指标水平均呈正直线相关(P<0.01或P<0.05);多元逐步回归分析显示Alb/cr、HbA1c水平为影响空腹血浆PAI-1水平的显著因素,其中HbA1c可以解释空腹血浆PAI-1浓度变化的49.3%、Alb/cr可以解释空腹血浆PAI-1浓度变化的28.9%(校正的R2值分别为0.493、0.782,P均<0.01)。结论 (1)T2DM患者血浆PAI-1水平升高,而且伴有MAU阳性的患者血浆PAI-1水平升高更为明显。(2)血浆PAI-1水平与MAU水平呈正直线相关,表明PAI-1可能是糖尿病血管并发症发生的一个危险因素。
Objective To investigate the changes of PAI-1 in plasma and the correlation with plasma microalbumin (MAU) in type 2 diabetes mellitus (T2DM) patients and explore the role of PAI-1 in the pathogenesis of type 2 diabetes mellitus and its vascular complications. Methods Sixty untreated untreated patients with T2DM (observation group) and 30 healthy subjects (control group) matched with the clinical data of T2DM patients were selected as the study subjects. According to the MAU test results, the observation group was divided into two groups: normal MAU Subgroups (30 cases) and MAU positive subgroups (30 cases). The levels of FBG, FINS, HbA1c, lipids (TC, TG, LDL-C and HDL -C), plasma PAI-1, MAU, etc., and the application of statistical software SPSS11.0 test results for the corresponding statistical analysis. Results The levels of FBG, HbA1c, TC, TG and LDL-C in the observation group were significantly higher than those in the control group (P <0.01 or P <0.05), but there was no significant difference between the two groups (P> 0.05) There was no significant difference between the two subgroups in observation group (P> 0.05). (2) There was no significant difference in the FINS level between the normal subgroup of MAU and the control group (P> 0.05), but the FINS level in the MAU positive subgroup was significantly higher than that in the control group (P <0.05) Statistical significance (P> 0.05). (3) The level of HOMA-IR in the observation group was significantly higher than that in the control group (P <0.05), but there was no significant difference between the two subgroups in the observation group (P> 0.05). (4) Plasma levels of PAI-1 in two subgroups of the observation group were significantly higher than those in the control group (P <0.01), and PAI-1 levels in the MAU positive subgroup were also significantly higher than those in the normal MAU subgroup (P <0.01). (5) Plasma PAI-1 levels were positively correlated with Alb / cr, HOMA-IR, FBG, HbA1c, BMI, TC, TG and other indicators (P <0.01 or P < Cr and HbA1c levels were the significant factors influencing the level of PAI-1 in fasting plasma, HbA1c could explain 49.3% of the change of fasting plasma PAI-1 concentration, Alb / cr could explain the change of fasting plasma PAI-1 concentration 28.9% (corrected R2 Values were 0.493,0.782, P <0.01). Conclusions (1) Plasma PAI-1 levels are elevated in patients with T2DM, and PAI-1 levels in patients with MAU positive are more pronounced. (2) Plasma PAI-1 level was positively correlated with MAU level, indicating that PAI-1 may be a risk factor for diabetic vascular complications.