| 于牧鑫 马瑞爽 司宇 吴晓明 邓瑞娟 张妍 史文杰 解汝娟.糖尿病肾病致凝血异常的研究[J].,2015,15(19):3784-3785 |
| 糖尿病肾病致凝血异常的研究 |
| Research on the Coagulopathy of Diabetic Nephropathy |
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| DOI： |
| 中文关键词: 糖尿病肾病 凝血功能异常 高凝状态 |
| 英文关键词: Diabetic nephropathy Coagulopathy Hypercoagulable state |
| 基金项目:国家自然科学基金项目(81270588) |
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| 中文摘要: |
| 糖尿病(DM)已成为世界性的常见病，其发病率高，并且随着生活水平的改善，其发病率必然还会进一步加剧。血管病变是
DM的重要并发症之一，糖尿病肾病(DN)是糖尿病常见且严重的微血管并发症，与血栓形成密切相关。糖尿病肾病的进展伴随着
体内凝血活性和抗凝活性的失调，同时激活自身免疫系统，发生炎症反应。炎症应答过程中释放的炎症因子损伤肾小球内皮细
胞，导致抗凝活性减弱。DN 患者体内血细胞激活，微粒形成增多会加强凝血活性。此外，纤溶酶抑制剂(PAI-1)与纤溶酶激活剂
(tPA)的失衡会引起纤溶系统紊乱。这三个方面引起DN 患者体内的高凝状态加重，并因此加速肾功能恶化，导致肾小球率过滤降
低，系膜基质增多，最终引起肾小球硬化及终末期肾脏疾病。本文就糖尿病肾病致凝血异常的发生机制做一综述。 |
| 英文摘要: |
| Diabetes mellitus (DM) has become a common disease worldwide with a higher incidence of complications. Vascular
disease is one of the most sever complication of DM. Diabetic nephropathy (DN) is a common complication which is closely related to
the thrombus formation of microvascular system. The progression of diabetic nephropathy is accompanied with dysfunction of
procoagulant and anticoagulant factors in vivo and simultaneously activated the immune system which could lead to the inflammation.
Inflammatory cytokines will be released during the inflammatory response and damage the endothelial cell that decreased anticoagulant
activity. Moreover, the increased procoagulant factor Xa and microparticles will enhance the clotting activity. The imbalance of
plasminogen activator inhibitor (PAI-1) and tissue-type plasminogen activator (tPA) can cause disorders of fibrinolytic system. These
three aspects caused a hypercoagulable state in patients with DN and promote the deterioration of renal function, finally, resulting in
reduced glomerular filtration rate, mesangial matrix increase, and eventually the glomerulosclerosis and end-stage renal disease. In this
study, we will make a review about the mechanismof coagulopathy in diabetic nephropathy. |
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