血栓弹力图在糖尿病肾病患者中的应用价值

Application Value of Thromboelastography in Diabetic Nephropathy

目的分析血栓弹力图各参数在糖尿病肾病不同发展阶段的变化,探讨血栓弹力图对糖尿病肾病的应用价值。方法选取2021年7月至2023年6月我院门诊及住院2型糖尿病患者145例,检测尿白蛋白与肌酐比值(UACR),根据UACR分为正常蛋白尿组48例,微量蛋白尿组53例和大量蛋白尿组44例,同时选取40名健康对照者(NC组),分别检测血栓弹力图参数R、K、MA、Angle角和常规凝血功能参数PT、APTT、FIB、D-D。结果与NC组比较,正常蛋白尿组R值和K值减少,差异有统计学意义(P<0.05)。微量蛋白尿组与正常蛋白尿组比较,以及大量蛋白尿组与微量蛋白尿组比较,R值和K值缩减少,Angle角增大,差异有统计学意义(P<0.05),MA值增大,差异有统计学意义(P<0.01)。各组间FIB、D-D值差异有统计学意义(P<0.05),PT、APTT值差异无统计学意义(P>0.05)。R值和K值与FIB呈负相关,MA值和Angle角与FIB值呈正相关。结论血栓弹力图能反映机体凝血功能全过程,对糖尿病肾病患者进行血栓弹力图检测有利于全面判断机体凝血状态,更好地进行病情评估。

Objective To analyze the changes of the parameters of thromboelastography in different stages of diabetic nephropathy development,and to explore the application value of thromboelastography in diabetic nephropathy.Methods A total of 145 outpatients and inpatients with type 2 diabetes mellitus were from July 2021 to June 2023.The ratio of urinary albumin to creatinine(UACR)was measured,according to UACR,there were 48 cases in normal proteinuria group,53 cases in microalbuminuria group,and 44 cases in macroalbuminuria group,simultaneously select 40 healthy controls(NC group).The parameters of thromboelastography including R,K,MA,Angle and the parameters of routine coagulation function including PT,APTT,FIB,D-D were measured respectively.Results Compared with the NC group,R and K values of the normal albuminuria group decreased,the difference was statistically significant(P<0.05).Compared with the normal albuminuria group,R and K values of the microalbuminuria group decreased,Angle values increased,the difference was statistically significant(P<0.05),the MA values increased,the difference was statistically significant(P<0.01).The same results were seen in the macroalbuminuria group compared with the microalbuminuria group.There were significant differences in FIB and D-D between groups,the difference was statistically significant(P<0.05),but no significant differences in PT and APTT(P>0.05).R and K value were negatively correlated with FIB,MA and Angle were positively correlated with FIB.Conclusions Thrombelastogram can reflect the whole process of coagulation function of the body.The detection of thrombelastogram in diabetic nephropathy patients is helpful to judge the coagulation state of the body and evaluate the condition of the patients.