血清蛋白质脂蛋白（a）和凝血纤溶指标在2型糖尿病肾脏病患者中的检测价值  

Value of lipoprotein （a）and the coagulation and fibrinolysis indexes in the detection of patients with type 2 diabetic kidney disease

作　　者：傅巧[1] 毛佩菊[1] 

机构地区：[1]上海交通大学医学院附属同仁医院肾脏内科,上海200336

出　　处：《中华航海医学与高气压医学杂志》2016年第4期305-308,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：国家自然基金面上项目（81270814）

摘　　要：目的：探析血清蛋白质脂蛋白（a）[Lp（a）]和凝血纤溶各指标水平的改变在2型糖尿病肾脏病（DKD）患者中的临床检测价值。方法分析2014年12月至2016年2月在我院接受治疗的68例2型糖尿病（DM）患者的临床资料，根据有无肾病将入选者分成观察1组（2型DM无肾病患者，24例）和观察2组（DKD患者，44例）2组。另外选取同期在我院30例健康体检者作为对照组。比较3组患者的基线资料、血脂水平、Lp（a）以及D-二聚体（D-Dimer）以及纤维蛋白原（Fg）等凝血纤溶指标的水平。多因素分析2型DM患者发生DKD的独立危险因子，并相关性分析2型DKD患者血清Lp（a）与凝血纤溶指标。结果3组患者的基线资料比较差异无统计学意义（P＞0．05）。观察1组和观察2组的总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL-C）和高密度脂蛋白（HDL-C）的含量均明显高于对照组，差异有统计学意义（P＜0．05）；观察1组的载脂蛋白 B（ApoB）水平和观察2组的载脂蛋白 A （ApoA）水平均明显高于对照组，差异有统计学意义（P＜0．05）；观察2组的TC水平明显高于观察1组，差异有统计学意义（P＜0．05）。观察2组的Lp（a）、D-Dimer以及Fg水平均明显高于对照组和观察1组，差异有统计学意义（P＜0．05）。Lp（a）和Fg是2型DKD患者的独立危险因子（P＜0．05）。2型DKD患者血清Lp（a）与凝血纤溶指标呈正相关（P＜0．01）。结论血清Lp（a）和凝血纤溶指标水平的检测在DKD的发生发展中具有重要的临床意义，可作为较好的临床检测指标。Objective To investigate the clinical value of lipoprotein （a）and changes in various coagulation and fibrinolysis indexes in the detection of patients with type 2 diabetic kidney disease （DKD）. Methods The clinical data of 68 diabetes mellitus （DM）patients with type 2 DKD admitted into our hospital from December,2014 to February,2016,were analyzed retrospectively.The research subjects were divided into 2 groups：the observation group 1 （24 cases of T2DM patients without DKD）and the observation group 2 （44 cases of T2DM patients with DKD）by depending on whether or not they had kidney disease.In addition, 30 healthy subjects who received routine health checks at our hospital during the same time span were chosen as the control group.The general medical data,levels of blood fat,Lp（a）,fibrinogen （Fg）and D-Dimer were compared.Independent risk factors of T2 DM patients were analyzed,and the association between the levels of Lp（a）and the indexes of coagulation and fibrinolysis was also analyzed.Results No statistical significance could be noted in general medical data of the patients in the 3 groups,when comparisons were made between them （P＆gt;0.05 ）.The levels of TC,TG,LDL-C,HDL-C in the observe group 1 and 2 were all obviously higher than those in the control group,with statistical significance （P〈0.05 ）.The level of ApoB in the＆amp;nbsp;observe group 1 and the level of ApoA in the observe group 2 were higher than those in the control group,also with statistical significance （P〈0.05）.The level of TC in the observe group 2 was significantly higher than that in the observe group 1 ,and statistical significance could be noticed when comparisons were made between them （P〈0.05）.The levels of Lp（a）,D-Dimer,Fg in the observe group 2 were remarkably higher than those in the control group and the observation group 1 ,and statistical importance could also be seen when comparisons were made between them （P〈0.05）.Lp（a）and Fg were independent risk factors of

关 键 词：蛋白质脂蛋白(a) 凝血活性 纤溶活性 2型糖尿病 糖尿病肾脏病 LIPOPROTEIN (a ) 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]