论文部分内容阅读
目的:观察糖尿病肾脏病进展过程中血纤溶酶原激活物抑制剂-1的水平变化及应用药物干预其变化后产生的对糖尿病肾脏病的影响。方法:选择于聊城市人民医院就诊的糖尿病肾脏病患者88例,DKDⅢ期43例,DKDⅣ期45例。分别检测各期患者血PAI-1水平,观察其变化趋势。针对DKDⅢ期患者分为对照组(DKDⅢ-C组)和观察组(DKDⅢ-O组),对照组给予常规降糖、保护肾脏及血管紧张素转化酶抑制剂等药物治疗。观察组在对照组治疗的基础上给予尿激酶5万U加入100ml生理盐水静脉滴注,每天1次,共14d。比较两组治疗前后血PAI-1水平、24 h尿白蛋白量、血肌酐、空腹血糖和凝血酶原时间的变化。结果:DKDⅣ期患者血PAI-1水平明显高于DKDⅢ期患者(P<0.001)。DKDⅢ-O组患者治疗后血PAI-1水平下降(P<0.01),且尿白蛋白减少程度有统计学意义(P<0.01),空腹血糖、血肌酐、凝血酶原时间影响无统计学差异(P>0.05)。DKDⅢ-C组治疗前、后血PAI-1、24h尿白蛋白量、空腹血糖、血肌酐、凝血酶原时间变化均无统计学差异(P>0.05)。结论:随糖尿病肾脏病进展,血PAI-1水平呈上升趋势,应用药物降低其水平后可减少早期DKD患者尿白蛋白量,对保护肾功能、延缓肾脏病进展有积极意义。
Objective: To observe the changes of plasminogen activator inhibitor-1 in the development of diabetic nephropathy and its effect on the diabetic nephropathy after intervention with the medicine. Methods: 88 patients with diabetic nephropathy who were selected for treatment in Liaocheng People’s Hospital, 43 patients in DKD stage Ⅲ and 45 in DKD Ⅳ stage were selected. PAI-1 levels were measured in patients with various stages of blood and observed the trend. The patients with DKD stage Ⅲ were divided into control group (DKDⅢ-C group) and observation group (DKDⅢ-O group). The control group were given conventional hypoglycemic agents and protective drugs such as renal and angiotensin converting enzyme inhibitors. Observation group in the control group based on the treatment given urokinase 50000 U intravenous infusion of 100ml saline once a day for 14 days. The levels of PAI-1, 24 h urinary albumin, serum creatinine, fasting blood glucose and prothrombin time in both groups were compared before and after treatment. Results: The level of plasma PAI-1 in patients with DKD Ⅳ was significantly higher than that in patients with DKD Ⅲ (P <0.001). The plasma levels of PAI-1 in DKDⅢ-O group decreased (P <0.01), and the reduction of urinary albumin was statistically significant (P <0.01). There was no significant difference in fasting blood glucose, serum creatinine and prothrombin time (P> 0.05). There was no significant difference in urinary albumin, fasting blood glucose, serum creatinine and prothrombin time before and after PAI-1,24h in DKDⅢ-C group (P> 0.05). CONCLUSIONS: With the progression of diabetic nephropathy, PAI-1 level in blood is on the rise. Reducing the level of urinary albumin in patients with early DKD can decrease the level of urinary albumin, which has a positive effect on the protection of renal function and the progression of renal disease.