[1]张曙晴,张骆军,李洪彬,等.血液小而密低密度脂蛋白胆固醇、抗凝血酶Ⅲ水平及血小板参数检测在2型糖尿病肾病中的应用价值研究[J].现代检验医学杂志,2021,36(02):70-74.[doi:doi:10.3969/j.issn.1671-7414.2021.02.017]
 ZHANG Shu-qing,ZHANG Luo-jun,LI Hong-bin,et al.Study on the Application Value of Detecting Small Dense Low-density Lipoprotein Cholesterol, Antithrombin-Ⅲ Levels and Platelet Parameter in the Patients with Type-2 Diabetic Nephropathy[J].Journal of Modern Laboratory Medicine,2021,36(02):70-74.[doi:doi:10.3969/j.issn.1671-7414.2021.02.017]
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血液小而密低密度脂蛋白胆固醇、抗凝血酶Ⅲ水平及血小板参数检测在2型糖尿病肾病中的应用价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年02期
页码:
70-74
栏目:
论 著
出版日期:
2021-04-30

文章信息/Info

Title:
Study on the Application Value of Detecting Small Dense Low-density Lipoprotein Cholesterol, Antithrombin-Ⅲ Levels and Platelet Parameter in the Patients with Type-2 Diabetic Nephropathy
文章编号:
1671-7414(2021)02-070-06
作者:
张曙晴张骆军李洪彬
(南通市第二人民医院a.检验科;b.内分泌科,江苏南通 226002)
Author(s):
ZHANG Shu-qing ZHANG Luo-junLI Hong-bin et al
(a.Department of Clinical Laboratory;b.Department of Endocrinology, the Second People’s Hospital of Nantong, Jiangsu Nantong 226002,China)
关键词:
小而密低密度脂蛋白胆固醇抗凝血酶Ⅲ血小板参数糖尿病肾病
分类号:
R587.2;R446.112
DOI:
doi:10.3969/j.issn.1671-7414.2021.02.017
文献标志码:
A
摘要:
目的 检测血液小而密低密度脂蛋白胆固醇(sdLDL-C)、抗凝血酶Ⅲ(AT-Ⅲ)以及血小板参数,探讨其在2型糖尿病肾病(DN)中的临床应用价值。方法 收集南通市第二人民医院内分泌科2018年8月~2020年1月期间2型糖尿病(T2DM)患者305例,根据24 h尿微量清蛋白排泄率(UAE)分为无蛋白尿组163例(UAE<30mg/24h)、微量清蛋白尿组113例(30mg/24h≤UAE<300mg/24h)和大量清蛋白尿组29例(UAE≥300mg/24h),另选取同期健康体检者80例作为对照组,比较血糖(GLU)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),sdLDL-C,AT-Ⅲ,血小板(PLT),平均血小板体积(MPV)和血小板分布宽度(PDW)的变化。结果 T2DM病例组sdLDL-C,MPV和PDW均显著高于对照组(t=27.312,16.233和6.566,均P<0.05),AT-Ⅲ活性低于对照组(t=10.347,P<0.01),差异均有统计学意义。无蛋白尿组、微量清蛋白尿组及大量清蛋白尿组sdLDL-C浓度依次升高,AT-Ⅲ活性依次下降(F=28.984,21.483,P<0.01);微量清蛋白尿组MPV和PDW显著高于无蛋白尿组(t=7.009,6.352,P<0.01);大量清蛋白尿组MPV低于微量清蛋白尿组(t=2.300,P<0.05),差异均有统计学意义。Pearson相关分析显示sdLDL-C与UAE呈正相关(相关系数r=0.624,P<0.01),AT-Ⅲ活性与UAE呈负相关(r=-0.468,P<0.01)。logistic回归分析显示高sdLDL-C,高MPV,高PDW和低AT-Ⅲ活性是DN发生的危险因素(P<0.05)。ROC曲线分析显示sdLDL-C,AT-Ⅲ,MPV和PDW联合检测诊断DN曲线下面积(AUC)、敏感度和特异度分别为0.785,81.3%和86.5%。结论 sdLDL-C,AT-Ⅲ,MPV及PDW联合检测为2型糖尿病肾病早期诊断、病情监测以及预后判断提供新的依据。

参考文献/References:

[1] BAN Bo, BAI Bo, ZHANG Manman, et al. Low serum cartonectin/CTRP3 concentrations in newly diagnosed type 2 diabetes mellitus: in vivo regulation of cartonectin by glucose[J]. PLoS One, 2014, 9(11): e112931.
[2] 杨庭显,康海岩.血清 RBP4与 sdLDL 联合检测与2型糖尿病患者并发动脉粥样硬化的相关性分析[J].中国实验诊断学, 2016, 20(9):1457-1459. YANG Tingxian,KANG Haiyan.The relationship between the level of serum RBP4 and sdLDL in type 2 diabetes patients with atherosclerosis [J] . Chinese Journal of Laboratory Diagnosis, 2016, 20(9):1457-1459.
[3] 韩晶晶,杨帆,周旭强,等.急性缺血性脑卒中患者血清小而密低密度脂蛋白胆固醇水平与心脑血管狭窄程度的相关性研究[J].现代检验医学杂志,2020, 35(3): 42-46. HAN Jingjing,YANG Fan,ZHOU Xuqiang,et al.Study on the correlation between low density lipoprotein (LDL) cholesterol level and the severity of cardiovascular and cerebrovascular stenosis in patients with acute ischemic stroke[J]. Journal of Modern Laboratory Medicine, 2020, 35(3): 42-46.
[4] 刘倩,符潮,唐青海,等.人抗凝血酶Ⅲ研究进展[J].衡阳师范学院学报, 2018, 39(3):128-132. LIU Qian,FU Chao,TANG Qinghai,et al.Advances on research in human antithrombin Ⅲ[J] .Journal of Hengyang Normal University,2018,39(3) :128-132.
[5] GONCALVES S C, LABINAZ M, LE MAY M, et al. Usefulness of mean platelet volume as a biomarker for long-term outcomes after percutaneous coronary intervention[J]. The American Journal of Cardiology, 2011, 107(2): 204-209.
[6] SCHULTE D M, PAULSEN K, TUERK K, et al. Small dense LDL cholesterol in human subjects with different chronic inflammatory diseases[J]. Nutrition Metabolism and Cardiovascular Diseases, 2018, 28(11): 1100-1105.
[7] 任利民, 高鑫, 林寰东, 等.新诊断2型糖尿病血脂谱特点及低密度脂蛋白颗粒直径的影响因素分析[J].复旦学报(医学版), 2008, 35(2): 282-285. REN Limin, GAO Xin, LIN Huandong, et al. Dyslipidemia feature of newly diagnosed type 2 diabetes and influential factors of low density lipoprotein size[J]. Fudan University Journal of Medical Sciences, 2008, 35(2): 282-285.
[8] MORIYAMA K, TAKAHASHI E. Non-HDL cholesterol is a more superior predictor of small-dense LDL cholesterol than LDL cholesterol in Japanese subjects with TG levels <400 mg/dl[J]. Journal of Atherosclerosis and Thrombosis, 2016, 23(9): 1126-1137.
[9] 林杰,陈力平,孔维菊,等.2型糖尿病患者血清小而密LDL胆固醇水平、脂类代谢紊乱情况以及胰岛素治疗对脂类代谢的影响[J].中华内分泌代谢杂志, 2013, 29(12): 1021-1025. LIN Jie,CHEN Liping,KONG Weiju,et al.Serum small and dense low-density lipoprotein-cholesterol and lipoproteins levels in type 2 diabetic patients and the influence of insulin therapy on lipid metabolism[J]. Chinese Journal of Endocrinology and Metabolism, 2013, 29(12): 1021-1025.
[10] 李红霞,李伊凡,李珊珊,等.小而密低密度脂蛋白胆固醇血清水平与2型糖尿病相关性研究[J].精准医学杂志, 2018, 33(6): 474-477. LI Hongxia, LI Yifan, LI Shanshan, et al.Association between serum small dense low-density lipoprotein cholesterol and type 2 diabetes mellitus[J].Journal of Precision Medicine, 2018, 33(6): 474-477.
[11] 黄子初.冠心病患者血清小而密低密度脂蛋白胆固醇与同型半胱氨酸、D-二聚体含量分析[J].标记免疫分析与临床, 2017, 24(1): 55-57. HUANG Zichu.Analysis between serum small dense low-density lipoprotein cholesterol and homocysteine, D-dimer in patients with coronary heart disease[J]. Labeled Immunoassays and Clinical Medicine, 2017, 24(1): 55-57.
[12] 龚倩,胡月明,王金金.小而密低密度脂蛋白及常见血脂指标与冠心病的相关性研究[J].标记免疫分析与临床, 2017, 24(8): 845-849. GONG Qian,HU Yueming,WANG Jinjin.Relationship between small, dense low-density lipoprotein,common serum lipid index and coronary heart disease[J].Labeled Immunoassays and Clinical Medicine,2017,24(8):845-849.
[13] 刘肖瑛,林佩娜,欧阳伟庆,等.2型糖尿病患者血清sdLDL和脂类水平及相关性分析[J].现代检验医学杂志, 2020, 35(3): 58-61. LIU Xiaoying,LIN Peina,OUYANG Weiqing,et al. Analysis of serum sdLDL and lipid levels and their correlation in patients with type 2 diabetes[J].Journal of Modern Laboratory Medicine, 2020,35(3): 58-61.
[14] 尹栩芳,沈霞.冠心病患者血浆抗凝血酶Ⅲ活性和纤维蛋白原水平的临床价值[J].现代检验医学杂志,2014, 29(3): 141-143. YIN Xufan,SHEN Xia.Clinical values of plasma anti-thrombin-Ⅲ activity and fibrinogen level in patients with coronary heart disease[J].Journal of Modern Laboratory Medicine, 2014, 29(3): 141-143.
[15] 周丽.抗凝血酶Ⅲ与肾病综合征[J].国际泌尿系统杂志,2019,39(5):951-953. ZHOU Li.Relationship between antithrombin-Ⅲ and nephrotic syndrome[J]. International Journal of Urology and Nephrology ,2019,39(5):951-953.
[16] MARCHETTI V, MENGHINI R, RIZZA S, et al. Benfotiamine counteracts glucose toxicity effects on endothelial progenitor cell differentiation via Akt/FoxO signaling[J]. Diabetes, 2006, 55(8): 2231-2237.
[17] 闫吉,王雅姝.动态监测抗凝血酶Ⅲ和D-二聚体在急性心肌梗死诊疗中的应用[J].中国实验诊断学,2015, 19(1): 45-47. YAN Ji,WANG Yashu.Dynamic monitoring of AT-Ⅲ and D-dimer application in the diagnosis and treatment of acute myocardial infarction[J].Chinese Journal of Laboratory Diagnosis, 2015, 19(1):45-47.
[18] 陈乐闻,李剑,罗心平.高脂血症与血小板活化关系的研究进展[J].医学综述, 2015, 21(11): 1948-1951. CHEN Lewen,LI Jian,LUO Xin-ping. The advances of the relationship between hyperlipidemia and platelet activation[J] .Medical Recapitulate,2015, 21(11): 1948-1952.
[19] 曲云霄,蒋知新,韩腾龙,等.血小板参数及活化标志物与2型糖尿病患者颈动脉内膜中层厚度的相关性[J].实用医学杂志, 2016, 32(8): 1250-1253. QU Yunxiao,JIANG Zhixin,HAN Tenglong,et al. Correlation of carotid intima-media thickness with platelet parameters and markers of platelet activation in patients with type 2 diabetes mellitus[J]. the Journal of Practical Medicine, 2016, 32(8):1250-1253.
[20] MARTIN J F, KRISTENSEN S D, MATHUR A, et al. The causal role of megakaryocyte–platelet hyperactivity in acute coronary syndromes[J]. Nature Reviews Cardiology, 2012, 9(11): 658-670.
[21] ULUTAS K T, DOKUYUCU R, SEFIL F, et al. Evaluation of mean platelet volume in patients with type 2 diabetes mellitus and blood glucose regulation: a marker for atherosclerosis?[J]. International Journal of Clinical and Experimental Medicine, 2014, 7(4): 955-961.
[22] 薛静, 吕丽霞, 李巍, 等.平均血小板体积在健康及空腹血糖受损人群中分布水平的研究[J].中华检验医学杂志, 2014, 37(6): 451-454. XUE Jing,Lü Lixia,LI Wei,et al.Distribution of mean platelet volume in the healthy and impaired fasting glucose individuals[J] .Chinese Journal of Laboratory Medicine, 2014, 37(6): 451-454.
[23] 马伟军,董萍.平均血小板体积与空腹血糖水平的相关性研究[J].中国疗养医学, 2017, 26(4): 429-431. MA Weijun,DONG Ping.Study on the correlation between mean platelet volume and fasting glucose [J].Chinese Journal of Convalescent Medicine,2016, 26(4): 429-431.

相似文献/References:

[1]韩晶晶,杨 帆,周旭强,等.急性缺血性脑卒中患者血清小而密低密度脂蛋白胆固醇水平与心脑血管狭窄程度的相关性研究[J].现代检验医学杂志,2020,35(03):42.[doi:10.3969/j.issn.1671-7414.2020.03.010]
 HAN Jing-jing,YANG Fan,ZHOU Xu-qiang,et al.Study on the Correlation between Low Density Lipoprotein (LDL) Cholesterol Level and the Severity of Cardiovascular and Cerebrovascular Stenosis in Patients with Acute Ischemic Stroke[J].Journal of Modern Laboratory Medicine,2020,35(02):42.[doi:10.3969/j.issn.1671-7414.2020.03.010]

备注/Memo

备注/Memo:
作者简介:张曙晴(1977- ),女 ,本科,副主任技师,主要从事临床生物化学检验,E-mail:zhangshuqing9216@sina.com。
通讯作者:张骆军,男,副主任技师,E-mail:307968986@qq.com。
更新日期/Last Update: 2021-04-10