[1]刘倩倩,鲁作华,王 星,等.血浆D- 二聚体在2 型糖尿病患者早期肾损伤中的应用价值[J].现代检验医学杂志,2020,35(04):134-138.[doi:10.3969/j.issn.1671-7414.2020.04.034]
 LIU Qian-qian,LU Zuo-hua,WANG Xing,et al.Application Value of Serum D-Dimer in Early Kidney Injury in Patients with Type 2 Diabetes[J].Journal of Modern Laboratory Medicine,2020,35(04):134-138.[doi:10.3969/j.issn.1671-7414.2020.04.034]
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血浆D- 二聚体在2 型糖尿病患者早期肾损伤中的应用价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第35卷
期数:
2020年04期
页码:
134-138
栏目:
检验与临床
出版日期:
2020-09-05

文章信息/Info

Title:
Application Value of Serum D-Dimer in Early Kidney Injury in Patients with Type 2 Diabetes
文章编号:
1671-7414(2020)04-134-05
作者:
刘倩倩鲁作华王 星韩书光赵晓静汤 沛刘兴晖
(上海市浦东新区公利医院检验科,上海 200135)
Author(s):
LIU Qian-qian LU Zuo-huaWANG Xing HAN Shu-guang ZHAO Xiao-jing TANG Pei LIU Xing-hui
(Department of Clinical Laboratory,Gongli Hospital of Pudong New Area in Shanghai, Shanghai 200135, China)
关键词:
2 型糖尿病肾脏疾病D- 二聚体纤维蛋白原胱抑素C
分类号:
R587.2;R446.112
DOI:
10.3969/j.issn.1671-7414.2020.04.034
文献标志码:
A
摘要:
目的 研究D- 二聚体(D-D) 对2 型糖尿病(T2DM)患者早期肾脏疾病风险评估的临床应用价值。方法 选取内分泌病房305 例2 型糖尿病患者作为研究对象,根据预估肾小球滤过率(eGFR)分为三组,分别为组I:eGFR≥ 90ml/(min· 1.73m-2); 组II:eGFR:60~89ml/(min· 1.73m-2) 和组III:eGFR 30 ~ 59m/(min · 1.73m-2), 检测D-D,纤维蛋白原(FIB),胱抑素C(Cys-C)和尿清蛋白/ 肌酐比值(ACR)等指标;再以D-D 的75% 分位数分组为DD ≤ 0.46mg/L 和D-D>0.46mg/L,对两组患者检测指标进行单因素分析;以eGFR<60ml/(min· 1.73m-2)作为肾损伤判定标准,进行D-D,FIB 和Cys-C 对肾损伤风险Logistic 回归及诊断指标的分析。结果 组I,II 和III 之间两两比较:得到组III 中DD,Cys-C 和FIB 分别与组II 和组I 比较,差异均有统计学意义(F=0.26,P<0.01,F=0.34,P<0.01;F=0.60,P<0.01,F=0.90,P<0.01;F=0.92,P<0.01,F=0.92,P<0.01),得到组II 中DD 和Cys-C 与组I 差异有统计学意义(F=0.08,P<0.01,F=0.3,P<0.01);DD 分组进行比较:D-D>0.46mg/L 组患者的尿ACR,FIB,Cys-C 和eGFR 阳性率均高于D-D ≤ 0.46mg/L 组,差异有统计学意义(χ2=16.50,47.74,69.11,89.91,均P<0.01);Logistic 回归分析:DD,FIB 和Cys-C 水平升高发生肾功能损伤的风险高于正常水平,差异有统计学意义[Exp(B)=6.07,P<0.01,Exp(B)=3.76,P<0.01,Exp(B)=53.34 P<0.01)],三指标联合检测的诊断试验的ROC 曲线下面积是0.943。结论 血浆D- 二聚体水平与2 型糖尿病患者早期肾损伤的发生存在相关性。D- 二聚体,FIB 和Cys-C 水平与2 型糖尿病患者肾脏疾病的进展相关,并且三者联合检测对肾脏疾病风险的预测具有临床意义。

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备注/Memo

备注/Memo:
收稿日期:2020-02-04 修回日期:2020-03-13基金项目:浦东新区卫生系统重点学科群建设资助( PWZxq2017-15);浦东新区卫生系统领先人才培养计划(PWRI2018-05)。作者简介:刘倩倩(1981-),女,学士学位,主管技师,检验科门急诊组长,从事血液体液临床检验及血栓与止血的临床研究,E-mail:qianqianliu25@163.com。通讯作者:刘兴晖,男,主任技师,E-mail:liuxh@163.com。
更新日期/Last Update: 2020-10-08