2型糖尿病肾病患者不同时期凝血功能与血脂水平的变化及其临床意义

Changes of coagulation function and blood lipid level of patients with type 2 diabetes nephropathy during different periods and its clinical significance

目的检测2型糖尿病肾病患者不同时期的凝血功能和血脂水平,探讨其临床意义。方法选择我院住院治疗的2型糖尿病肾病患者150例作为研究对象,其中正常蛋白尿患者、微量白蛋白尿患者和临床蛋白尿患者各50例。选择该院接受健康体检的健康人群50例作为对照组。检测各研究对象的空腹血糖、甘油三酯、同型半胱氨酸、糖化血红蛋白、凝血酶原时间、活化部分凝血酶时间、纤维蛋白原水平及凝血酶时间等相关指标,并对各指标数据进行对比分析。同时采用多元线性回归分析,以尿总蛋白为应变量,以FBG、TG、HCY、Hb A1C为自变量分析各指标间的相关性。结果 2型糖尿病肾病患者FBG、TG、FIB均显著高于对照组,且临床蛋白尿组显著高于与正常蛋白尿组及微量白蛋白尿组(P均<0.05),患者TT显著延长(P<0.05),临床蛋白尿组的HCY显著高于正常尿蛋白组(P<0.05);FBG、TG、HCY、Hb A1C作为自变量对应变量MTP的影响大小依次为HCY、FBG、TG以及Hb A1C。结论与正常人相比,T2DN患者表现为血脂水平异常以及凝血功能紊乱;随着MAU的升高,患者的HCY、Hb A1C以及FIB数据指标逐渐升高,TT也逐渐延长;对MTP的影响最大的因素为HCY以及FBG。

Objective To test coagulation function and blood lipid level of patients with type 2 diabetes nephropathy during different periods and explore its clinical significance. Methods 150 patients with type 2 diabetes nephropathy who were hospitalized and treated in Dongguan Hospital of Traditional Chinese Medicine were selected as research subject including 50 patient with normal proteinuria, 50 patients with microalbuminuria and 50 patient with clinical proteinuria. 50 people who were received physical examination in our hospital were selected as control group. Fasting blood-glucose, triglycerid, homocysteine, glycosylated hemoglobin, prothrombin time, activated partial thromboplastin time, fibrinogen and thrombin time of research subjects were tested, and all the index and data were compared and analyzed. Multivariate linear regression analysis was used and set MTP as dependent variable and set FBG, TG, HCY, HbAIC as independent variable to analyze correlation of these index. Results FBG, TG and FIB of patients with T2DN were significantly higher than those of control group, and those of patients with clinical proteinuria were significantly higher than those of patient with normal proteinuria and patients with microalbuminuria （P〈0.05）. Patients＇ TT was significantly prolonged （P〈0.05）. HCY of patients with clinical proteinuria was significantly higher than that of patients with normal proteinuria （P〈0.05）. The influence extent of independent variable including FBG, TG, HCY, HbA1C on dependent variable of MTP was HCY, FBG, TG and HbA1C in sequence. Conclusion Compared with common people, patients with T2DN have the symptoms of abnormal blood lipid levels and coagulation function disturbance. With the increase of MAU, the patients＇ HCY, HbA1C and FIB are gradually increased and TT is gradually prolonged. The greatest influence factors to MTP are HCY and FBG.