The Study of Coagulation and Anti-Coagulation on Patient with Diabetic Nephropathy

Objective To study the role of TM,PC,AT,TAT levels in the onset and development of diabetic nephropathy(DN).Methods The levels of thrombomodulin(TM),protein C(PC),antithrombin (AT),thrombin-antithrombin complex(TAT),were measured in 30 normal control group and 90 patients with type 2 diabetes mellitus(DM)group.The DM patients were divided into four groups according to their urinary albumin excretion(UAE):complication free group(n=30,UAE＜12mg/24h);group A with nor- mal albuminuria(n=20,UAE 12～30 mg/24 h);group B with microalbuminuria(n=20,UAE 30～300 rag/24 h);group C with macroalbuminuria(n=20,UAE＞300 mg/24 h).Results(1)The plasma PC, TAT levels in DM group are higher than the normal controls(P＜0.05).The plasma AT in DM group are low- er than the normal controls(P＜0.05),it even exits in complication free group.Multiple regression analysis shows the UAE is correlated with respectively(β=0.407,0.312,P＜0.05),course of diabetes is correlated with AT negatively(β=-3.69,P＜0.01).(2)The plasma TM in DM group are higher than the normal con- trols,although there is no significant difference between the normal control group and the complication free group,there is significant difference among the rest(P＜0.05).Multiple regression analysis shows tht UAE is correlated with plasma TM respectively(β=0.321,P＜0.01).Conclusion(1)Type 2 diabetes pa- tients usually exist vascular endothelial injury,hypercoagulability,the plasma level of TM,PC,AT,TAT may reflect to some certain extent coagulation changes in type 2 diabetes patients.(2)The plasma TM is a sen- sitive marker of early diagnosis of DN,and reflects the onset and development of DM,the test of UAE are useful for early diagnosis of DN.