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目的观察2型糖尿病(DM)患者血浆蛋白C(PC)活性、抗凝血酶Ⅲ(AT-Ⅲ)在糖尿病肾病(DN)各期的水平,探讨其在DN发生、发展中的作用。方法检测38例正常人和125例2型DM患者蛋白C活性(PC)、抗凝血酶Ⅲ(AT-Ⅲ)。根据24h尿蛋白排泄(UAE)将患者分为两组:无并发症组(UAE<30mg/24h)45例;尿蛋白组(UAE>30mmg/24h)80例。结果DM无蛋白尿和蛋白尿组血浆PC水平分别为124.1±10.7%和171.5±36.5%,与正常对照组血浆PC水平102.3±17.3%比较有显著性差异(p<0.05),而且两组比较也有显著性差异(p<0.05);DM无蛋白尿和蛋白尿组AT-Ⅲ活性分别为79.4±29.4%和40.6±13.2%,与正常对照组(95.4±6.5%)比较有显著性差异(p<0.05),而且两组比较也有显著性差异(p<0.05)。结论DM患者存在血管内皮损伤、血液高凝状态,PC、AT-Ⅲ在一定程度上可反映DM凝血功能变化,并能反映DN的发生和发展。
Objective To observe the activity of plasma protein C (PC) and the level of AT-Ⅲ in patients with type 2 diabetes mellitus (DM) at different stages of diabetic nephropathy (DN) and to explore its role in the occurrence and development of DN. Methods Protein C activity (PC) and antithrombin Ⅲ (AT-Ⅲ) were detected in 38 normal subjects and 125 type 2 DM patients. The patients were divided into two groups according to urinary protein excretion (UAE): 45 cases without complications (UAE <30mg / 24h) and 80 cases with urinary protein (UAE> 30mmg / 24h). Results The plasma PC levels in DM without proteinuria and proteinuria were 124.1 ± 10.7% and 171.5 ± 36.5%, respectively, which were significantly different from those in the normal control group (102.3 ± 17.3%, p <0.05) There was also a significant difference (p <0.05). AT-Ⅲ activity in DM without proteinuria and albuminuria were 79.4 ± 29.4% and 40.6 ± 13.2%, respectively, which was significantly different from that in the normal control group (95.4 ± 6.5% p <0.05), but there was also a significant difference between the two groups (p <0.05). Conclusion DM patients have vascular endothelial injury, blood hypercoagulable state, PC, AT-Ⅲ to some extent, reflect the changes of DM coagulation function, and can reflect the occurrence and development of DN.