血浆PAI-1、Fg与糖尿病肾病的相关性研究

黎镇赐 罗义 吕婧 杨阳

[摘要] 目的 探讨2型糖尿病患者血浆中纤溶酶原激活物抑制物-1和纤维蛋白原活性水平变化及其与糖尿病肾病的相关性。 方法 对168例心内科的2型糖尿病患者及52例健康体检者检查血糖、空腹胰岛素、血脂、尿酸、血常规、凝血功能、PAI-1、Fg，测量血压、腰围、身高和体重并计算体重指数；根据尿蛋白排泄率分为正常对照组52例，2型糖尿病无DN组48例、DN微量白蛋白尿组66例、DN临床蛋白尿组54例；分析PAI-1、Fg与糖尿病肾病的相关性。 结果 与正常对照组相比，2型糖尿病组患者PAI-1、Fg水平明显升高，差异有统计学意义（P＜0.05），且PAI-1、Fg水平随着UAER的增高而递增。多元回归分析显示，2型糖尿病患者的血浆PAI-1、Fg水平与UAER独立相关，提示体内PAI-1、Fg水平的高低与糖尿病肾病密切相关。 结论 2型糖尿病患者炎症标志物PAI-1、Fg水平增高，PAI-1、Fg水平与糖尿病肾病密切相关，提示PAI-1、Fg水平升高可能是2型糖尿病合并微血管病变的危险因素。

[关键词] 纤溶酶原激活物抑制物-1；纤维蛋白原；2型糖尿病；糖尿病肾病

[中图分类号] R587.2???[文献标识码] A???[文章编号] 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

糖尿病肾病（diabetic nephropathy，DN）已成为糖尿病死亡主要的病因之一，它是糖尿病常见的慢性并发症。迄今为止DN的发病机制尚未完全明确。目前研究表明，DN肾脏损害主要源于微血管病变，凝血功能异常在微血管病变中具有举足轻重的作用[1]。而血浆纤溶酶原激活物抑制物-1（PAI-1）、纤维蛋白原（Fg）是凝血、纤溶系统的重要调节因子。本研究旨在分析2型糖尿病合并糖尿病肾病患者的PAI-1、Fg的变化规律，为早期发现糖尿病微血管病变患者提供依据，现报道如下。

1?资料与方法

1.1?一般资料

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（收稿日期：2012-06-07）