中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2009年
3期
1-3
,共3页
方玲%钟建庭%于晓辉%赵治华
方玲%鐘建庭%于曉輝%趙治華
방령%종건정%우효휘%조치화
糖尿病肾病%血红蛋白A,糖基化%组织型纤溶酶原激活物%纤溶酶原激活物抑制物1
糖尿病腎病%血紅蛋白A,糖基化%組織型纖溶酶原激活物%纖溶酶原激活物抑製物1
당뇨병신병%혈홍단백A,당기화%조직형섬용매원격활물%섬용매원격활물억제물1
Diabetic nephropathies%Hemoglobin A,glycosylated%Tissue plasminogen activator%Plasminogen activator inhibitor-1
目的 探讨糖化血红蛋白(GHbA1c)对糖尿病肾病(DN)早期患者组织型纤溶酶原激活物(t-PA)以及纤溶酶原激活物抑制物-1(PAI-1)活性的影响.方法 2004年4月至2005年5月收治DN早期患者90例.根据GHbA1c水平分为3组,每组各30例.A组GHbAlc＜7%,B组GHbA1c7%-9%,C组GHbA1c＞9%,另选择健康体检者30例作为对照组.所有入选者在清晨空腹抽血测定GHbA-C、t-PA、PAI-1.结果 与对照组比较,DN各组GHbAlC、t-PA、PAI-1差异均有统计学意义(P＜0.05或＜0.01),其中t-PA活性下降,而PAI-1活性上升.C组与A组比较t-PA活性下降[分别为(0.14±0.06)、(0.28±0.11)U/ml],PAI-1活性上升[分别为(3.25±1.01)、(1.90±1.09)U/m1],差异均有统计学意义(P＜0.05);而B组与A组比较t-PA活性有下降趋势,PAI-1活性有上升趋势,但差异均无统计学意义(P＞0.05).结论 DN早期患者体内存在着纤溶系统的失衡,持续高血糖状态进一步破坏纤溶系统,严格控制GHbA1c达标是延缓糖尿病及其并发症发生和发展的重要因素之一.
目的 探討糖化血紅蛋白(GHbA1c)對糖尿病腎病(DN)早期患者組織型纖溶酶原激活物(t-PA)以及纖溶酶原激活物抑製物-1(PAI-1)活性的影響.方法 2004年4月至2005年5月收治DN早期患者90例.根據GHbA1c水平分為3組,每組各30例.A組GHbAlc＜7%,B組GHbA1c7%-9%,C組GHbA1c＞9%,另選擇健康體檢者30例作為對照組.所有入選者在清晨空腹抽血測定GHbA-C、t-PA、PAI-1.結果 與對照組比較,DN各組GHbAlC、t-PA、PAI-1差異均有統計學意義(P＜0.05或＜0.01),其中t-PA活性下降,而PAI-1活性上升.C組與A組比較t-PA活性下降[分彆為(0.14±0.06)、(0.28±0.11)U/ml],PAI-1活性上升[分彆為(3.25±1.01)、(1.90±1.09)U/m1],差異均有統計學意義(P＜0.05);而B組與A組比較t-PA活性有下降趨勢,PAI-1活性有上升趨勢,但差異均無統計學意義(P＞0.05).結論 DN早期患者體內存在著纖溶繫統的失衡,持續高血糖狀態進一步破壞纖溶繫統,嚴格控製GHbA1c達標是延緩糖尿病及其併髮癥髮生和髮展的重要因素之一.
목적 탐토당화혈홍단백(GHbA1c)대당뇨병신병(DN)조기환자조직형섬용매원격활물(t-PA)이급섬용매원격활물억제물-1(PAI-1)활성적영향.방법 2004년4월지2005년5월수치DN조기환자90례.근거GHbA1c수평분위3조,매조각30례.A조GHbAlc＜7%,B조GHbA1c7%-9%,C조GHbA1c＞9%,령선택건강체검자30례작위대조조.소유입선자재청신공복추혈측정GHbA-C、t-PA、PAI-1.결과 여대조조비교,DN각조GHbAlC、t-PA、PAI-1차이균유통계학의의(P＜0.05혹＜0.01),기중t-PA활성하강,이PAI-1활성상승.C조여A조비교t-PA활성하강[분별위(0.14±0.06)、(0.28±0.11)U/ml],PAI-1활성상승[분별위(3.25±1.01)、(1.90±1.09)U/m1],차이균유통계학의의(P＜0.05);이B조여A조비교t-PA활성유하강추세,PAI-1활성유상승추세,단차이균무통계학의의(P＞0.05).결론 DN조기환자체내존재착섬용계통적실형,지속고혈당상태진일보파배섬용계통,엄격공제GHbA1c체표시연완당뇨병급기병발증발생화발전적중요인소지일.
Objective To investigate the effect ofglycesylated hemoglobin(GHbA,c) on tissue-type plasminngen activator (t-PA)and level of serum plasminogen activator inhibitor-1 (PAI-1) in patients with early diabetic nephropathy (DN).MethodNinety patients with early DN from April 2004 to May 2005 were divided into 3 groups according to the level of GHbA1c,which was respectively less than 7% (group A),between 7% and 9% (group B),and more than 9% (greup C).Thirty healthy adults were chosen as control group.The levels of serum GHbA1c,t-PA and PAI-1 were detected on empty stomach in the morning.Results The level of serum t-PA was lower,the activity of PAI-1 was higher in groups of DN than those in control group (P＜0.05 or＜0.01),and those were changed with the level of GHbA,c.There were significant differences between group C and group A[t-PA:(0.14± 0.06),(0.28± 0.11) U/ml; PAI-1 (3.25 ±1.01),(1.90q± 1.09) U/ml](P＜0.05).Conclusions The fibrinolytic system exists unbalance in patients with early DN.Continuous hyperglycemia in patients with early DN make unbalanced fibrinolytic system more serious.Controlling the level of GHbA1c strictly can play an important role in delaying DN progress.
