血漿PAI-1、Fg與糖尿病腎病的相關性研究

黎鎮賜 羅義 呂婧 楊陽

[摘要] 目的 探討2型糖尿病患者血漿中纖溶酶原激活物抑制物-1和纖維蛋白原活性水平變化及其與糖尿病腎病的相關性。 方法 對168例心內科的2型糖尿病患者及52例健康體檢者檢查血糖、空腹胰島素、血脂、尿酸、血常規、凝血功能、PAI-1、Fg，測量血壓、腰圍、身高和體重并計算體重指數；根據尿蛋白排泄率分為正常對照組52例，2型糖尿病無DN組48例、DN微量白蛋白尿組66例、DN臨床蛋白尿組54例；分析PAI-1、Fg與糖尿病腎病的相關性。 結果 與正常對照組相比，2型糖尿病組患者PAI-1、Fg水平明顯升高，差異有統計學意義（P＜0.05），且PAI-1、Fg水平隨著UAER的增高而遞增。多元回歸分析顯示，2型糖尿病患者的血漿PAI-1、Fg水平與UAER獨立相關，提示體內PAI-1、Fg水平的高低與糖尿病腎病密切相關。 結論 2型糖尿病患者炎癥標志物PAI-1、Fg水平增高，PAI-1、Fg水平與糖尿病腎病密切相關，提示PAI-1、Fg水平升高可能是2型糖尿病合并微血管病變的危險因素。

[關鍵詞] 纖溶酶原激活物抑制物-1；纖維蛋白原；2型糖尿病；糖尿病腎病

[中圖分類號] R587.2???[文獻標識碼] A???[文章編號] 2095-0616（2012）15-20-03

Correlation of PAI-1 and Fg with diabetic nephropathy

LI?Zhenci??LUO?Yi??LV?Jing??YANG?Yang

Department of Cardiology,the First People's Hospital of Guangzhou City, Guangzhou 510180,China

[Abstract] Objective To research the correlation of plasminogen activator inhibitor-1 and fibrinogen with diabetic nephropathy. Methods 220 cases were selected which included 168 in-patients with T2DM from cardiology department and 52 healthy residents.Systolic blood pressure, diastolic pressure, waist circumference, body mass index were tested based on weight and height. Plasma lipids, fasting blood glucose, fasting insulin, uric acid, and the blood levels of Fg and PAI-1 were also measured separately. The plasmic levels of PAI-1 and Fg in diabetic patients with or without diabetic nephropathy and normal controls were tested.Correlation of PAI-1 and Fg levels in T2DM patients with DN was analyzed. Results The blood levels of PAI-1 and Fg in patients with T2DM were higher than those health residents(P＜0.05), and those were elevated in accordance with UAER. The stepwise regression analysis showed that the blood levels of PAI-1 and Fg were independently associated with UAER. Conclusion Diabetic nephropathy may be correlated with the high levels of PAI-1 and Fg, which may be risk factors of T2DM with microangiopathic.

[Key words] Plasminogen activator inhibitor-1;Fibrinogen;Type 2 diabetes mellitus;Diabetic nephropathy

糖尿病腎病（diabetic nephropathy，DN）已成為糖尿病死亡主要的病因之一，它是糖尿病常見的慢性并發癥。迄今為止DN的發病機制尚未完全明確。目前研究表明，DN腎臟損害主要源于微血管病變，凝血功能異常在微血管病變中具有舉足輕重的作用[1]。而血漿纖溶酶原激活物抑制物-1（PAI-1）、纖維蛋白原（Fg）是凝血、纖溶系統的重要調節因子。本研究旨在分析2型糖尿病合并糖尿病腎病患者的PAI-1、Fg的變化規律，為早期發現糖尿病微血管病變患者提供依據，現報道如下。

1?資料與方法

1.1?一般資料

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（收稿日期：2012-06-07）