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目的观察血浆蛋白C(PC)、抗凝血酶Ⅲ(AT-Ⅲ)在2型糖尿病肾病(DN)各期的水平,探讨其在DN发生与发展的作用。方法检测30例正常人和84例2型糖尿病(DM)患者PC、AT-Ⅲ水平。根据24 h尿蛋白定量(UAE)将患者分为4组:单纯DM组(UAE<15 mg/24 h)20例;A组:尿白蛋白正常组(UAE15~30 mg/24 h)22例;B组:微量尿白蛋白组(UAE 30~300 mg/24 h)21例;C组:大量尿白蛋白组(UAE>300 mg/24 h)21例。结果 DM各组血浆PC水平高于正常对照组,AT-Ⅲ活性低于正常对照组,差异均有统计学意义(均P<0.05);在DM无并发症时即出现上述改变。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,与UAE联合监测有助于早期诊断DN。
Objective To observe the levels of plasma protein C (PC) and antithrombin Ⅲ (AT-Ⅲ) in patients with type 2 diabetic nephropathy (DN) and to explore their roles in the occurrence and development of DN. Methods The levels of PC and AT-Ⅲ in 30 normal subjects and 84 patients with type 2 diabetes mellitus (DM) were measured. The patients were divided into 4 groups according to 24-hour urinary proteinuria (UAE): 20 patients in the DM group (UAE <15 mg / 24 h) and 22 patients in the normal urine albumin group (UAE 15 to 30 mg / 24 h) ; Group B: 21 cases of microalbuminuria group (UAE 30 ~ 300 mg / 24 h); 21 cases of group C (UAE> 300 mg / 24 h). Results The levels of plasma PC in each group were higher than those in normal control group, and the activity of AT-Ⅲ was lower than that in normal control group (all P <0.05). The above changes were observed when there was no complication of DM. Conclusion DM patients have vascular endothelial injury and hypercoagulable state. PC, AT-Ⅲ can reflect the changes of coagulation function of DM to a certain extent, and can reflect the occurrence and development of DN. Combined with UAE, it is helpful to diagnose DN early.