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目的:探讨活化蛋白C(APC)与2型糖尿病肾病(DKD)患者动脉粥样硬化的关系。方法:ELISA方法检测41例2型糖尿病肾病患者和27位对照组志愿者的血浆APC水平,颈动脉超声测量颈动脉内中膜厚度(IMT)作为全身动脉粥样硬化的衡量指标。结果:与对照组相比,2型糖尿病肾病患者的血浆APC水平显著性降低[(10389.0±1801.9)vs(6693.3±1790.5)ng/ml,P<0.001]。单因素相关分析显示,2型糖尿病肾病非透析患者的颈动脉IMT与血浆APC水平(r=-0.511,P<0.01)负相关。多元逐步线性回归分析显示APC是平均颈动脉IMT的显著性相关因素(β=-0.492,P<0.01),且24h尿白蛋白排泄率(β=-0.719,P<0.05)、血红蛋白(β=0.522,P<0.05)是血浆APC水平的显著性相关因素。结论:APC的减少可能与2型糖尿病肾病患者的动脉粥样硬化相关,并可能在其动脉粥样硬化的病理过程中发挥作用。
Objective: To investigate the relationship between activated protein C (APC) and atherosclerosis in type 2 diabetic nephropathy (DKD). Methods: Plasma APC levels were measured in 41 patients with type 2 diabetic nephropathy and 27 control subjects by ELISA. Carotid artery IMT was used as a measure of systemic atherosclerosis. Results: Plasma APC levels in patients with type 2 diabetic nephropathy were significantly lower than those in controls (10389.0 ± 1801.9 vs 6693.3 ± 1790.5 ng / ml, P <0.001). Univariate analysis showed that carotid IMT was negatively correlated with plasma APC level (r = -0.511, P <0.01) in patients with type 2 diabetic nephropathy. Multivariate stepwise linear regression analysis showed that APC was significantly associated with mean carotid artery IMT (β = -0.492, P <0.01) and urinary albumin excretion rate (β = -0.719, P <0.05) 0.522, P <0.05) was a significant correlate of plasma APC levels. Conclusion: The decrease of APC may be related to atherosclerosis in patients with type 2 diabetic nephropathy and may play a role in the pathogenesis of atherosclerosis.