糖尿病肾病的血液流变性分析

Clinical Analysis of Diabetic Nephropathy on Hemorheology

目的 研究糖尿病肾病（DN）的血液流变学特征,并分析其形成的病理生理学基础.方法 根据糖尿病及DN诊断标准选择研究对象125例.分为糖尿病肾病组（DN组）34例,单纯糖尿病组（DM组）46例,正常糖耐量组（NGT组）45例,对各组进行血液流变学指标、血脂、超敏C反应蛋白（hs-CRP）及糖化血红蛋白（HbA1C）检测,结果进行分析.结果 （1）三组间比较,各参数均有意义（P〈0.01）;（2）与NGT组比较,DM组血浆黏度、红细胞压积、红细胞刚性指数、TC及LDL-C增高LP〈0.05）,红细胞变形指数下降（P〈0.05）,其他参数差异显著（P〈0.01）;DN组与DM组比较,所有血液流变学参数差异与DM组和NGT组的比较结果相一致（P〈0.05或P〈0.01）,TC和LDL-C增高（P〈0.05）,TG、hs-CRP增高显著（P〈0.01）,HDL-C有显著下降（P〈0.01）.结论 糖尿病随病程进展,红细胞变形性进行性下降,聚集性逐级增强;DN普遍的多水平发病机制共同参与了血液流变性的演变.

Objective To study the blood rheology characteristics of diabetic nephropathy（DN） and analyze the basis for the formation of their pathophysiological. Method According to diagnostic criteria of diabetes mellitus and DN,125 patients were chosen and divided into 3 groups：diabetic nephropathy group（DN group） 34 cases,simple diabetic group（DM group） 46 cases and normal glucose tolerance group （NGT group） 45 cases.Of each group,hemorheology, blood lipid,high-sensitivity C-reactive protein（hs-CRP） and glycosylated hemoglobin（HbA1c） were tested and the results were analyzed. Result （1）Comparing among the three groups,all parameters have statistical significance（P 〈 0.01）;（2）Compared with NGT group,plasma viscosity, hematocrit,RBC rigidity index,TC and LDL-C in DM group were higher（P 〈 0.05）,RBC deformability index in DM group decreased（P 〈 0.05）,and the other parameters significantly differ（P 〈 0.01）,Compared with DM group,the difference of all hemorheological parameters did accord with that between DM group and NGT group（P 〈 0.05 or P 〈 0.01）,TC and LDL-C increased significantly（P 〈 0.05）and so did TG,hs-CRP（P 〈 0.01）,while HDL-C decreased significantly（P 〈 0.01）.Conclusion With the progression of diabetes,red blood cell deformability progressively decreased,while the aggregation gradually increased. DN popular multi-level is co-involved in the pathogenesis of the development of blood theology.