【摘要】 目的 探讨血浆血栓调节蛋白(TM)在糖尿病性肾病患者中的变化以了解其在微血管病变发病中的意义。方法 检测58例2型糖尿病患者血浆TM与内皮素(ET)的水平，并与30例正常人进行比较。结果 (1)糖尿病组血浆TM水平明显高于正常对照组(P<0.001)，其中临床糖尿病肾病组血浆TM水平明显高于早期糖尿病肾病组(P<0.001)及尿白蛋白正常的糖尿病组(P<0.01)；(2)血浆TM水平与尿白蛋白排泄率、ET水平呈显著正相关(r=0.5390和0.5650，P均<0.005)。结论 血浆TM水平测定对2型糖尿病性肾病的早期诊断和病情分析有重要的临床价值。

【Abstract】 Objective Tomeasure the plasma levels of thrombomodulin (TM) in patients with diabetic nephropathy andto study the significance of TM in the pathogenesis of microangiopathy. Methods The levels of plasma TM were measured by ELISA in 30 normalcontrols (NC group) and 58 cases with type 2 diabetes mellitus (DM group), including 10cases without albuminuria (SDM group), 29 cases with microalbuminuria (EDN group) and 19cases with macroalbuminuria (CDN group). Plasma endothelin (ET) levels were measured by RAST simultaneously. Results The levels of plasma TM were markedly elevated in DM, SDM, EDN andCDN groups than in NC group (P<0.001, 0.05, 0.001and 0.001, respectively). The plasma TM levels in CDN group were significantly higher thanthose in SDM and EDN groups (P=0.003and P<0.001, respectively). There was a positivecorrelation between plasma TM and urinary albumin excretion rate (r=0.5390,P<0.005), and between plasma TM and plasma ET (r=0.5650, P<0.005) in groups with diabetic nephropathy. Conclusions The measurement of plasma TM is useful in evaluating the early diagnosis and severity intype 2 diabetic nephropathy.

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