目的：探究D-二聚体、纤维蛋白原（ FIB）及抗凝血酶Ⅲ（ AT-Ⅲ）联合检测2型糖尿病早期肾损伤的临床诊断价值。方法选取某院2型糖尿病患者206例，根据24 h尿白蛋白排泄率（ UAE）分为无蛋白尿组116例（ UAE＜30 mg／24 h）与微量白蛋白尿组90例（30 mg／24 h≤UAE＜300 mg／24 h），并选取同期健康体检者103例作为健康对照组，比较血浆D-二聚体、FIB、AT-Ⅲ3项指标的变化。结果微量白蛋白尿组D-二聚体、FIB含量明显高于无蛋白尿组和健康对照组，差异均有统计学意义（P＜0畅05），而三组AT-Ⅲ的活性比较差异无统计学意义（P＞0畅05）。3项指标联合检测的微量蛋白尿组患者为93畅3％，比单项检测的阳性率高，差异有统计学意义（P＜0畅05）。 D-二聚体、FIB、AT-Ⅲ与尿白蛋白排泄率呈正相关，相关系数（r）依次为0畅812、0畅672、0畅621（P＜0畅05）。结论 D-二聚体、FIB检测对于2型糖尿病肾病的早期判断以及疾病的早期预防和病情监测有重要意义。%Objective To explore the D-dimer, fibrinogen (FIB), antithrombin Ⅲ (AT-Ⅲ) joint detection of early renal damage in type 2 diabetes to assess the diagnostic value of clinical application.Methods According to the 24 h urine albumin excre-tion rate ( UAE) , 206 patients selected from type 2 diabetes patients were divided into 116 cases without albuminuria group ( UAE<30 mg/24 h) and microalbuminuria group 90 cases (30 mg/24 h≤UAE<300 mg/24 h) , and select the healthy physical examina-tion is 103 people for the same period as the healthy control group, comparison of plasma D-dimer, FIB, the AT-Ⅲthree indicators of change.Results Microalbuminuria group D-dimer, FIB levels were significantly higher than those without albuminuria group and healthy control group, the difference had statistical significance (P<0.05), and comparison of three groups of the AT-Ⅲ activity, there was no statistically significant difference (P>0.05).Three indicators of joint detection of trace albuminuria group of patients was 93.3%, positive rate than single detection are high, the difference was statistically significant (P<0.05).D-dimer, FIB, the AT-Ⅲand UAE are positively related to the level of the correlation coefficient r of 0.812, 0.672, and 0.621 (P<0.05).Conclusion The detection of D-dimer, FIB in type 2 diabetic nephropathy early judgement and early prevention of disease and illness monitoring is im-portant.
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