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目的:探讨2型糖尿病肾病(DN)患者超敏C反应蛋白(hs-CRP)、血浆纤维蛋白原(FIB)及D-二聚体(DD)水平的变化及临床意义。方法:选择2型糖尿病患者132例,根据尿白蛋白排泄率(UAER)分为单纯糖尿病组(单纯DM组)40例,早期糖尿病肾病组(DN1组)47例,临床糖尿病肾病组(DN2组)45例,另选健康体检者50例做为对照组。应用免疫散射比浊法测定hs-CRP水平,用凝固法检测血浆FIB及DD,并进行组间比较;UAER与hs-CRP、FIB、DD做直线相关分析。结果:三组DN患者UAER、hs-CRP、FIB及DD水平与对照组比较水平升高,差别均具有统计学意义(P<0.05);DN1组、DN2组显著高于DM组(P<0.05),DN2组与DN1组相比亦明显升高(P<0.05)。直线相关分析显示hs-CRP、FIB及DD与UAER均呈正相关(r分别为0.835,0.761,0.707,P均<0.05)。结论:hs-CRP、FIB及DD可能在DN发生发展过程中起重要作用,监测该三项指标有助于对DN患者病情及预后的判断。
Objective: To investigate the changes of hs-CRP, fibrinogen (FIB) and D-dimer (DD) in patients with type 2 diabetic nephropathy (DN) and their clinical significance. Methods: 132 patients with type 2 diabetes mellitus (T2DM) were divided into two groups according to their urinary albumin excretion rate (UAER): 40 patients in simple diabetic group (DM group), 47 patients in early diabetic nephropathy group (DN1 group), DN2 diabetic nephropathy group ) 45 cases, another 50 cases of healthy physical examination as a control group. The level of hs-CRP was measured by immune nephelometry. The plasma FIB and DD were detected by coagulation method and compared between groups. The linear correlation analysis between UAER and hs-CRP, FIB and DD was made. Results: The levels of UAER, hs-CRP, FIB and DD in the three DN groups were significantly higher than those in the control group (P <0.05). The DN1 and DN2 groups were significantly higher than those in the DM group (P <0.05) ), DN2 group was also significantly higher than DN1 group (P <0.05). Linear correlation analysis showed that hs-CRP, FIB and DD were positively correlated with UAER (r = 0.835,0.761,0.707, P <0.05). Conclusion: hs-CRP, FIB and DD may play an important role in the development and progression of DN. To monitor these three indexes is helpful to judge the condition and prognosis of patients with DN.