糖尿病肾脏病与血纤溶酶原激活物抑制剂-1的相互影响

目的：观察糖尿痛肾脏病进展过程中血纤溶酶原激活物抑制剂-1的水平变化及应用药物干预其变化后产生的对糖尿病肾脏病的影响。方法：选择于聊城市人民医院就诊的糖尿病肾脏病患者88例，DKDⅢ期43例，DKDⅣ期45例。分别检测各期患者血PAI-1水平，观察其变化趋势。针对DKDⅢ期患者分为对照组（DKDⅢ-C组）和观察组（DKDⅢ-O组），对照组给予常规降糖、保护肾脏及血管紧张素转化酶抑制剂等药物治疗。观察组在对照组治疗的基础上给予尿激酶5万U加入100ml生理盐水静脉滴注，每天1次。共14d。比较两组治疗前后血PAI-1水平、24h尿白蛋白量、血肌酐、空腹血糖和凝血酶原时间的变化。结果：DKDⅣ期患者血PAI-1水平明显高于DKDⅢ期患者（P〈0．001）。DKDⅢ-O组患者治疗后血PAI-1水平下降（P〈0．01），且尿白蛋白减少程度有统计学意义（P〈0．01），空腹血糖、血肌酐、凝血酶原时间影响无统计学差异（P〉0．05）。DKDⅢ-C组治疗前、后血PAI-1、24h尿白蛋白量、空腹血糖、血肌酐、凝血酶原时间变化均无统计学差异（P〉0．05）。结论：随糖尿病肾脏病进展，血PAI-1水平呈上升趋势，应用药物降低其水平后可减少早期DKD患者尿白蛋白量，对保护肾功能、延缓肾脏病进展有积极意义。

The Interaction between Diabetic Kidney Disease and Blood Plasminogen Activator Inhibitor - 1

Objective： To observe the change of blood of plasminogen activator inhibitor -1 levels with the progression of diabetic kidney disease and using drugs to interfere with the changes resulting from the impact of diabetic kidney disease. Methods： Choose the DKD in Liaocheng people＇s hospital 88 patients, DKD Ⅲ period 43 cases, DKD Ⅳperiod 45 patients. Were detected in patients with blood levels of PAI-1, observed trends. DKD Ⅲof the patients were divided into control group （DKD Ⅲ-C group） and the observation group （DKDⅢ-O group）, Control group received routine blood glucose,kidney protection and angiotensin converting enzyme inhibitors and other drug treatment. Observed in the conventional treatment group was given 50,000 U of urokinase by adding 100ml normal saline infusion, day 1, a total of 14 d. The amount of PAI-1 blood levels ,24 hours urinary albumin, serum creatinine, fasting plasma glucose, and prothrombin time were compared. Results： DKD IV blood of patients with PAI-1 levels were significantly higher in patients with DKD III（P〈0.001 ）. DKD HI-O group after treatment, the amount of 24h urine protein and plasma PAI-1 were significantly lower （P 〈0. 01）, and fasting blood glucose, serum creatinine, prothrombin time before and after treatment were not statistically significant difference （P〉 0.05）.DKD Ⅲ-C group and DKD Ⅳ-C group before and after treatment the amount of 24h urinary albumin, fasting blood glucose, serum creatinine, prothrombin time and blood PAI-1 were not statistically different （P〉 0.05）. Conclusions： With the progress of DKD, Plasma PAl-1 levels rise. After application of medication to reduce its level of early DKD reduce the amount of urinary albumin, on the protection of renal function, and delay the progress of renal disease have a positive meaning.