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目的:检测2型糖尿病患者血清可溶性信号素4D水平，探讨其对糖尿病微血管并发症的预测价值。方法:将210例2型糖尿病患者按照微血管并发症发生状况分为单纯糖尿病组96例、单一并发症组77例和多并发症组37例。收集患者一般临床资料和实验室指标，采用酶联免疫吸附法检测各组血清可溶性信号素4D水平，并进行比较。采用多元有序Logistic回归分析糖尿病微血管并发症的危险因素，利用受试者工作特征曲线（ROC曲线）评价血清可溶性信号素4D对糖尿病微血管并发症的预测价值。结果:单纯糖尿病组、单一并发症组、多并发症组病程[（5.02 ±1.00）、（6.26 ± 2.13）、（8.42 ± 2.82）年]、收缩压（SBP）[（131.81 ± 18.06）、（141.81 ± 22.51）、（142.88 ± 17.06）mmHg，1 mmHg=0.133 kPa]、高血压患病率[37.5%（36/96）、50.6%（39/77）、35.1%（22/37）]、餐后血糖（PPG）[（13.56 ± 2.02）、（14.94 ± 2.50）、（15.88 ± 2.45）mmol/L]、糖化血红蛋白（HbAn lc）[（8.17 ± 2.17）%、（9.14 ± 1.51）%、（9.69 ± 1.58）%]及血清可溶性信号素4D水平[（1.18 ± 0.27）、（1.89 ± 0.53）、（2.21 ± 0.79）μg/L]比较差异有统计学意义（n P1.91 μg/L时（曲线下面积0.740），提示可能发生多种微血管并发症。n 结论:血清可溶性信号素4D是2型糖尿病患者合并微血管并发症的独立危险因素，其可以作为预测糖尿病微血管并发症的生物标志物。“,”Objective:To detect the levels of serum soluble semaphorin 4D in patients with type 2 diabetes, and to investigate the predictable value for diabetic microangiopathy (DMAP).Methods:A total of 210 type 2 diabetes patients were divided into non-DMAP group (96 cases), single-DMAP group (77 cases) and composite DMAP group (combination of two or three DMAP, 37 cases) according to the DMAP status. The general clinical data and laboratory indicators were collected, meanwhile, the levels of serum soluble semaphorin 4D were measured by enzyme-linked immunosorbent assay. The risk factors related to DMAP were analyzed by multiple ordered Logistic regression model, and the predictable value of serum soluble semaphorin 4D for DMAP was evaluated by receiver operating characteristic (ROC) curve.Results:The difference of course of diabetes [(5.02 ±1.00), (6.26 ± 2.13), (8.42 ± 2.82) years], systolic blood pressure (SBP)[(131.81 ± 18.06), (141.81 ± 22.51), (142.88 ± 17.06) mmHg, 1 mmHg=0.133 kPa], hypertension ratio [37.5%(36/96), 50.6%(39/77), 35.1%(22/37)], postprandial blood glucose (PPG)[(13.56 ± 2.02), (14.94 ± 2.50), (15.88 ± 2.45) mmol/L], hemoglobin (HbAn 1c) [(8.17 ± 2.17)%, (9.14 ± 1.51)%, (9.69 ±1.58)%], soluble semaphorin 4D [(1.18 ± 0.27), (1.89 ± 0.53), (2.21 ± 0.79) μg/L] among non-DMAP group, single-DMAP group, composite DMAP group had statistical significance ( n P1.91μg/L (AUC=0.740) may predictethe occurrence of composite DMAP.n Conclusions:Serum soluble semaphorin 4D is an independent risk factors for DMAP and may be considered as an potential serum maker to screen DMAP.