糖尿病肾病血液流变学的研究

Study of hemorheology in patients with diabetes nephropathy

目的探讨血液流变学各指标与糖尿病肾病(DN)之间的关系。方法对140例糖尿病住院患者血液流变学指标进行回顾性分析,根据尿蛋白排泄率将糖尿病患者分为单纯2型糖尿病组(DM组)68例和DN组72例,并与69例健康人(对照组)进行对照比较。结果与对照组比较,DM组与DN组血液流变学中全血黏度、全血高切/低切还原黏度、血沉、血沉方程K值、全血低切相对黏度,差异有统计学意义(P<0.05),DN组与DM组比较,全血黏度、全血低切还原/相对黏度、纤维蛋白原均高于DM组,差异有统计学意义(P<0.05),多元逐步回归分析显示,全血低切还原黏度、红细胞最大变性指数、纤维蛋白原可能为DN发生、发展的另一危险因素。结论 DN与血液流变学改变存在着密切的联系。

Objective To investigate the relationship between diabetic nephropathy and the hemorheological indexes.Methods 140 diabetic inpatients in our department were performed the retrospective analysis on the hemorheological indexes.The patients were divided into the simple diabetes group（DM,68 cases）and the diabetic nephropathygroup（DN,72 cases） according to theurinary albumin excretion rate（UAER） and compared with 69 healthy subjects as the control group.Results Compared with the control group,the hemorheological parameters of the whole blood viscosity,high shear/ low shear reduction viscosity,blood sedimentation,K-value of blood sedimentation equation and low shear blood relative viscosity in the DM and DN groups had statistical differences（P〈0.05）.The whole blood viscosity,high shear/low shear reduction viscosity and fibrinogen in the DN group were higher than those in the DM group with statistical difference（P〈0.05）.The multiple stepwise regression analysis showed that the low shear reduction blood viscosity,maximum index of erythrocyte deformability and fibrinogen could become the risk factors of the occurrence and development of DN.Conclusion The close realtion exists between DN with the hemorheological changes.