2型糖尿病肾病患者血D-二聚体及胆红素水平的变化及意义  

The Significance of Blood D-dimer and Bilirubin Levels in the Patients with Type 2 Diabetic Nephropathy

作　　者：韦翔[1] 葛平[1] 陶慧[1] 张清林[1] 周力[1] 徐颖[1] 王丹丹[1] 蒋聪颖 

机构地区：[1]江苏省东南大学医学院附属盐城医院输血科,224001

出　　处：《临床输血与检验》2015年第6期492-495,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨2型糖尿病肾病(DN)患者血D-二聚体及胆红素水平的变化及意义。方法选取165例2型糖尿病(T2DM)患者,依据尿白蛋白/肌酐比值(UACR)分成3组:正常蛋白尿(NA)组72例、微量白蛋白尿(MA)组56例、大量白蛋白尿(OA)组37例,检测血D-二聚体及胆红素水平,同时检测其他相关临床指标,分析D-二聚体及胆红素与其他实验指标的相关性,采用多元逐步回归分析UACR的主要影响因素;另选取40例健康体检者为正常对照(NC)组。结果在NC组、NA组、MA组及OA组中血D-二聚体水平依次增高,总胆红素(TBIL)、直接胆红素(DBIL)及间接胆红素(IBIL)水平依次降低,多组间比较及组内两两比较差异均有统计学意义(均P<0.05);D-二聚体与病程、UACR及肌酐(Cr)呈正相关,与TBIL及IBIL呈负相关;TBIL与病程及UACR呈负相关(均P<0.0 5);多元逐步回归分析表明,病程(β=0.1 6 9,P=0.017)、D-二聚体(β=0.192,P=0.008)及TBIL(β=0.183,P=0.011)是UACR的独立影响因素。结论糖尿病肾病患者存在高凝状态和低胆红素血症,且与病情有关。Objective To investigate the changes and significance of blood D-dimerand bilirubin levels in the patients with type 2 diabetic nephropathy（ DN）. Methods A total of 165 type 2 diabetes mellitus（ T2DM） patients were included and 40 healthy individuals as normal controls（ NC）. According to urinary albumin to creatinine ratios（ UACR）,the patients were divided into 3groups： 72 patients with normal albuminuria（ group NA）,56 patients with microalbuminuria（ group MA） and 37 patients with overalbuminuria（ group OA）. Blood D-dimer,bilirubin levels and relevant biochemical parameters were measured. The association between the D-dimer,bilirubin and other biochemical parameters were assayed in 165 T2 DM patients. The influencing factors of UACR were investigated by multiple stepwise regression analysis. Results The level of D-dimer increased progressively and total bilirubin（ TBIL）,direct bilirubin（ DBIL） and indirect bilirubin（ IBIL） decreased progressively from groups NC,NA,MA,and OA. And significant differences were seen among the groups（ all P〈0. 05）. D-dimer was positively associated with duration of diabetes,UACR and creatinine（ Cr） were negatively associated with TBIL and IBIL. TBIL was negatively associated with duration of diabetes and UACR. Multiple stepwise regression analysis indicated that duration of diabetes（ β = 0. 169,P = 0. 017）,D-dimer（ β= 0. 192,P = 0. 008） and TBIL（ β = 0. 183,P = 0. 011） were independent influencing factors for UACR. Conclusions Hypercoagulability and low level of seral bilirubin exist in DN patients and related to the state of disease.

关 键 词：糖尿病肾病 D-二聚体 胆红素 尿白蛋白/肌酐比值 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌] R446.11[医药卫生—内科学]