血浆D-二聚体浓度与2型糖尿病肾损害的相关性分析
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摘要
目的 :探讨2型糖尿病(T2DM)患者D-二聚体浓度与肾损害的相关性。方法 :收集2015年1月至2016年2月门诊收治的T2DM患者93例,按血浆D-二聚体浓度分为正常组48例和升高组45例,并收集45名体检合格者作为健康组。检测所有受试者的血浆D-二聚体浓度、尿白蛋白(Alb)浓度、肌酐浓度、尿白蛋白/肌酐(Alb/Cr)值、尿N-乙酰-β-D氨基葡萄糖酶(NAG)和肾小球滤过率(eGFR)。结果 :正常组、升高组和健康组的血浆D-二聚体浓度分别为(0.34)mg/ml、(1.10)mg/ml和(0.28)mg/ml,正常组和健康组间差异无统计学意义(P>0.05),但升高组与正常组和健康组间差异有统计学意义(P<0.05)。升高组与正常组和健康组的Alb/Cr、eGFR和NAG差异均有统计学意义(P<0.01)。T2DM患者血浆D-二聚体浓度与Alb/Cr和NAG呈显著正相关(P<0.01),与eGFR呈显著负相关(P<0.01)。结论 :血浆D-二聚体浓度与T2DM肾微血管、肾小球、肾小管损害关系密切,监测并调控D-二聚体浓度有助于糖尿病肾病的防治。
Objective: To investigate the correlation between the concentration of D-dimer and renal damage in patients with type 2 diabetes mellitus(T2 DM). Methods: Ninty-three cases of T2 DM patients admitted from January 2015 to February 2016 were collected and according to the concentration of plasma D-dimer they were divided into a normal group with 48 cases and an elevated group with 45 cases, and 45 qualified persons of physical examination were collected as the health group. Plasma D-dimer concentration, urinary albumin(Alb) concentration, creatinine concentration, urinary albumin/creatinine(Alb/Cr) value, urine N-acetylacetyl beta glucosaminidase(NAG) and glomerular filtration rate(eGFR) were detected in all subjects. Results: The concentration of plasma D-dimer in the normal group, the elevated group and the healthy group were(0.34) mg/ml,(1.10) mg/ml and(0.28) mg/ml, respectively, and there was no significant difference between the normal group and the healthy group(P>0.05). However, there was a significant difference between the elevated group and the normal group and the healthy group(P<0.05). The difference of Alb/Cr, eGFR and NAG between the elevated group and the normal group and the healthy group were statistically significant(P<0.01). The concentration of D-dimer in plasma of T2 DM patients was significantly positively correlated with Alb/Cr and NAG(P<0.01), and had a significant negative correlation with eGFR(P<0.01). Conclusion: The concentration of plasma D-dimer is closely related to T2 DM renal microvascular, glomeruli and renal tubule damage. Monitoring and regulating the concentration of D-dimer is helpful for the prevention and treatment of diabetic nephropathy.
Objective: To investigate the correlation between the concentration of D-dimer and renal damage in patients with type 2 diabetes mellitus(T2 DM). Methods: Ninty-three cases of T2 DM patients admitted from January 2015 to February 2016 were collected and according to the concentration of plasma D-dimer they were divided into a normal group with 48 cases and an elevated group with 45 cases, and 45 qualified persons of physical examination were collected as the health group. Plasma D-dimer concentration, urinary albumin(Alb) concentration, creatinine concentration, urinary albumin/creatinine(Alb/Cr) value, urine N-acetylacetyl beta glucosaminidase(NAG) and glomerular filtration rate(eGFR) were detected in all subjects. Results: The concentration of plasma D-dimer in the normal group, the elevated group and the healthy group were(0.34) mg/ml,(1.10) mg/ml and(0.28) mg/ml, respectively, and there was no significant difference between the normal group and the healthy group(P>0.05). However, there was a significant difference between the elevated group and the normal group and the healthy group(P<0.05). The difference of Alb/Cr, eGFR and NAG between the elevated group and the normal group and the healthy group were statistically significant(P<0.01). The concentration of D-dimer in plasma of T2 DM patients was significantly positively correlated with Alb/Cr and NAG(P<0.01), and had a significant negative correlation with eGFR(P<0.01). Conclusion: The concentration of plasma D-dimer is closely related to T2 DM renal microvascular, glomeruli and renal tubule damage. Monitoring and regulating the concentration of D-dimer is helpful for the prevention and treatment of diabetic nephropathy.
引文
[1]宋巧云,孙春秀,赵霞,等.D-二聚体、P选择素及超敏C反应蛋白联合检测在2型糖尿病肾病中的诊断价值[J].中国医学装备,2013,10(6):80-82.
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[5]王兴宁,李静,刘亚栋.尿微量白蛋白与肌酐比值在2型糖尿病早期损伤中的应用[J].昆明医科大学学报,2014,35(9):144-146.
[6]潘柏申.估算肾小球滤过率的建立与医学检验[J].中华检验医学杂志,2014,37(6):401-403.
[7]Zamora E,Lupón J,de Antonio M,et al.Long-term prognostic value for patients with chronic heart failure of estimated glomerular filtration rate calculated with the new CKD-EPI equations containing cystatin C[J].Clin Chem,2014,60(3):481-489.
[8]陈太金.血清胱抑素C,尿β2-微球蛋白和尿NAG酶在在糖尿病早期肾损伤中的意义[J].检验医学与临床,2011,8(15):1825-1826.
[2]Koracevic GP.Pragmatic classification of the causes of high D-dimer[J].AM J Emerg Med,2009,27(8):1016.e5-7.
[3]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2007年版)[J].中华医学杂志,2008,88(18):1227-1245.
[4]余国庆,窦念涛,孙红.D-二聚体、纤维蛋白原、胱抑素C与2型糖尿病肾病的关系[J].安徽医药,2014,18(12):2315-2317.
[5]王兴宁,李静,刘亚栋.尿微量白蛋白与肌酐比值在2型糖尿病早期损伤中的应用[J].昆明医科大学学报,2014,35(9):144-146.
[6]潘柏申.估算肾小球滤过率的建立与医学检验[J].中华检验医学杂志,2014,37(6):401-403.
[7]Zamora E,Lupón J,de Antonio M,et al.Long-term prognostic value for patients with chronic heart failure of estimated glomerular filtration rate calculated with the new CKD-EPI equations containing cystatin C[J].Clin Chem,2014,60(3):481-489.
[8]陈太金.血清胱抑素C,尿β2-微球蛋白和尿NAG酶在在糖尿病早期肾损伤中的意义[J].检验医学与临床,2011,8(15):1825-1826.