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目的探讨尿液组织因子(TF)含量及其促凝血活性(PCA)在不同尿微白蛋白水平的2型糖尿病(DM)患者中的变化及其意义。方法 86名2型DM患者按照尿白蛋白/肌酐(UACR)比共分为3组,即UACR<30mg/g的正常蛋白尿组42例,30mg/g≤UACR<300mg/g的微量白蛋白尿组26例,UACR≥300mg/g的大量白蛋白尿组18例,21名健康体检者为对照组。ELISA法测定各组尿液TF含量和一步凝固法检测TF-PCA活性。常规检测空腹血糖、糖化血红蛋白、超敏CRP(Hs-CRP)、肾功能。结果 DM组TF含量和PCA活性随尿蛋白水平升高而升高,在不同糖尿病组别间存在差异;尿液TF活性与尿素、肌酐、胱抑素C、hs-CRP、UACR、空腹血糖呈正相关(P<0.05),与其他测定指标无相关性,而尿液TF含量仅与hs-CRP、UACR呈正相关。结论 2型DM尤其是早期糖尿病肾病患者尿液TF呈高表达,可能与糖尿病肾病的发病机制、病程进展相关。
Objective To investigate the changes of urinary TF content and its procoagulant activity (PCA) in type 2 diabetes mellitus (DM) patients with different urine microalbumin levels and its significance. Methods Eighty-six type 2 DM patients were divided into three groups according to urinary albumin / creatinine (UACR) ratio: 42 cases of normal proteinuria with UACR <30mg / g, microalbumin with 30mg / g≤UACR <300mg / g Urine group, 26 cases, UACR≥300mg / g 18 cases of albuminuria, 21 healthy people as the control group. Urine TF content in each group was determined by ELISA and TF-PCA activity was detected by one-step coagulation assay. Fasting blood glucose, glycosylated hemoglobin, Hs-CRP and renal function were detected routinely. Results The levels of TF and PCA in DM group increased with the increase of urinary protein level, and there were differences in different diabetic groups. The urinary TF activity was positively correlated with urea, creatinine, cystatin C, hs-CRP, UACR and fasting blood glucose (P <0.05). There was no correlation with other indexes, but the urinary TF content was only positively correlated with hs-CRP and UACR. Conclusion Type 2 DM, especially in patients with early diabetic nephropathy, has a high expression of TF in urine, which may be related to the pathogenesis and progression of diabetic nephropathy.