糖尿病肾病进展与凝血异常的关系

The abnormality of coagulation and fibrinolysis in the progress of diabetic nephropathy

目的 探讨糖尿病肾病 (DN)患者凝血异常与尿蛋白和肾功能的关系。 方法 选择观察 8个月期间尿蛋白和肾功能变化相一致的 2 2例患者 ,分为二组 ,一组以华法林治疗 ,一组作为对照 ,每组各 11例。每月测一次血、尿肌酐和尿蛋白 ,华法林停用后第 2天检测各项凝血指标。 结果 尿蛋白增加和肾功能恶化作为 2个独立因素增强DN患者的凝血活性 ;抗凝治疗在改善凝血亢进状态后能延缓肾功能恶化 ,但不减少尿蛋白排泄。 结论 DN患者伴随尿蛋白增加血液高凝状态加重 。

Objective To investigate the relationship of coagulation fibrinolysis with urinary protein and renal function in patients with diabetic nephropathy (DN). Methods Hundred and six patients diagnosed as type 2 diabetes and DN were enrolled in the study. They were grouped according to urinary protein and renal function, and the parameters of coagulation and fibrionlysis were measured by ELISA method. Eleven cases with nephritic syndrome of 106 patients received 8 months warfarin therapy. Results Urinary protein increase and renal function depravation as two independent risk factors enhanced hypercoagulative activity in DN patients; anticoagulation therapy could obviously improve the state of coagulation and delayed the deterioration of renal function, but not decreased urinary protein. Conclusions Enhancement of coagulation activity was in concordance with urinary protein increase, which can exacerbate renal function in DN patients.