CAJ | 학술논문

目的：检测2型糖尿病肾病患者不同时期的凝血功能和血脂水平，探讨其临床意义。方法选择我院住院治疗的2型糖尿病肾病患者150例作为研究对象，其中正常蛋白尿患者、微量白蛋白尿患者和临床蛋白尿患者各50例。选择该院接受健康体检的健康人群50例作为对照组。检测各研究对象的空腹血糖、甘油三酯、同型半胱氨酸、糖化血红蛋白、凝血酶原时间、活化部分凝血酶时间、纤维蛋白原水平及凝血酶时间等相关指标，并对各指标数据进行对比分析。同时采用多元线性回归分析，以尿总蛋白为应变量，以FBG、TG、HCY、HbA1C为自变量分析各指标间的相关性。结果2型糖尿病肾病患者FBG、TG、FIB均显著高于对照组，且临床蛋白尿组显著高于与正常蛋白尿组及微量白蛋白尿组（P均＜0.05），患者TT显著延长（P＜0.05），临床蛋白尿组的HCY显著高于正常尿蛋白组（P＜0.05）；FBG、TG、HCY、HbA1C作为自变量对应变量MTP的影响大小依次为HCY、FBG、TG以及HbA1C。结论与正常人相比，T2DN患者表现为血脂水平异常以及凝血功能紊乱；随着MAU的升高，患者的HCY、HbA1C以及FIB数据指标逐渐升高，TT也逐渐延长；对MTP的影响最大的因素为HCY以及FBG。
목적：검측2형당뇨병신병환자불동시기적응혈공능화혈지수평，탐토기림상의의。방법선택아원주원치료적2형당뇨병신병환자150례작위연구대상，기중정상단백뇨환자、미량백단백뇨환자화림상단백뇨환자각50례。선택해원접수건강체검적건강인군50례작위대조조。검측각연구대상적공복혈당、감유삼지、동형반광안산、당화혈홍단백、응혈매원시간、활화부분응혈매시간、섬유단백원수평급응혈매시간등상관지표，병대각지표수거진행대비분석。동시채용다원선성회귀분석，이뇨총단백위응변량，이FBG、TG、HCY、HbA1C위자변량분석각지표간적상관성。결과2형당뇨병신병환자FBG、TG、FIB균현저고우대조조，차림상단백뇨조현저고우여정상단백뇨조급미량백단백뇨조（P균＜0.05），환자TT현저연장（P＜0.05），림상단백뇨조적HCY현저고우정상뇨단백조（P＜0.05）；FBG、TG、HCY、HbA1C작위자변량대응변량MTP적영향대소의차위HCY、FBG、TG이급HbA1C。결론여정상인상비，T2DN환자표현위혈지수평이상이급응혈공능문란；수착MAU적승고，환자적HCY、HbA1C이급FIB수거지표축점승고，TT야축점연장；대MTP적영향최대적인소위HCY이급FBG。
Objective To test coagulation function and blood lipid level of patients with type 2 diabetes nephropathy during different periods and explore its clinical significance.Methods 150 patients with type 2 diabetes nephropathy who were hospitalized and treated in Dongguan Hospital of Traditional Chinese Medicine were selected as research subject including 50 patient with normal proteinuria, 50 patients with microalbuminuria and 50 patient with clinical proteinuria. 50 people who were received physical examination in our hospital were selected as control group. Fasting blood-glucose, triglycerid, homocysteine, glycosylated hemoglobin, prothrombin time, activated partial thromboplastin time, fibrinogen and thrombin time of research subjects were tested, and all the index and data were compared and analyzed. Multivariate linear regression analysis was used and set MTP as dependent variable and set FBG, TG, HCY, HbA1C as independent variable to analyze correlation of these index. ResultsFBG, TG and FIB of patients with T2DN were significantly higher than those of control group, and those of patients with clinical proteinuria were significantly higher than those of patient with normal proteinuria and patients with microalbuminuria (P<0.05). Patients' TT was significantly prolonged (P<0.05). HCY of patients with clinical proteinuria was significantly higher than that of patients with normal proteinuria (P<0.05). The influence extent of independent variable including FBG, TG, HCY, HbA1C on dependent variable of MTP was HCY, FBG, TG and HbA1C in sequence. Conclusion Compared with common people, patients with T2DN have the symptoms of abnormal blood lipid levels and coagulation function disturbance. With the increase of MAU, the patients' HCY, HbA1C and FIB are gradually increased and TT is gradually prolonged. The greatest influence factors to MTP are HCY and FBG.