检验医学与临床2025，Vol.22Issue(8)：1100-1105,6.DOI:10.3969/j.issn.1672-9455.2025.08.018
TEG相关参数联合血清Hcy在2型糖尿病肾脏病变中的应用价值
The application value of TEG related parameters combined with serum Hcy in type 2 diabetes mellitus complicated by kidney lesions
摘要
Abstract
Objective To explore the application value of thromboelastogram(TEG)related parameters combined with serum homocysteine(Hcy)in type 2 diabetes mellitus(T2DM)complicated by kidney lesions.Methods A total of 120 inpatients with T2DM diagnosed in the hospital from January 2020 to December 2022 were retrospectively selected.According to the urine albumin to creatinine ratio(UACR)and estimated glo-merular filtration rate(eGFR),the patients were divided into the simple diabetes mellitus group[UACR<30 mg/g and eGFR≥90 mL/(min·1.73 m2),abbreviated as the DM group],the early diabetic kidney disease group[30 mg/g≤UACR<300 mg/g and 60 mL/(min·1.73 m2)≤eGFR<90 mL/(min·1.73 m2),abbre-viated as the eDKD group],and the clinical diabetic kidney disease group[UACR≥300 mg/g and eGFR<60 mL/(min·1.73 m2),abbreviated as the cDKD group].Compare the clinical data of each group.Pearson cor-relation analysis was used to analyze the correlation between UACR and the levels of serum Hcy,as well as TEG related parameters in patients with diabetic nephropathy(DKD).Multivariate Logistic regression analy-sis was employed to analyze the influencing factors of the occurrence of DKD in patients with T2DM.The re-ceiver operating characteristic curve(ROC)was plotted to analyze the predictive value of the separate and combined detections of serum Hcy and TEG related parameters for the occurrence of DKD in patients with T2DM.Results The levels of first admission systolic blood pressure(SBP),UACR,cystatin C(CysC),and uric acid(UA)in the cDKD group were higher than those in the eDKD group and the DM group,and those in the eDKD group were higher than those in the DM group,and the differences were statistically significant(P<0.05).The levels of serum Hcy,coagulation formation rate(Angel),final coagulation strength(MA),and comprehensive coagulation index(CI)in the cDKD group were higher than those in the DM group and the eDKD group,and the coagulation formation time(K)was shorter than that in the DM group and the eDKD group(P<0.05).The levels of serum Hcy,Angel,MA,and CI in the eDKD group were higher than those in the DM group,and K was shorter than that in the DM group(P<0.05).The results of Pearson correlation a-nalysis showed that the UACR in DKD patients was negatively correlated with K(r=-0.486,P<0.05),and was positively correlated with the level of serum Hcy,as well as the Angel,MA,and CI(r=0.511,0.470,0.586,0.455,P<0.05).The results of multivariate Logistic regression analysis showed that the increased levels of serum Hcy,first admission SBP,Angel,MA,and the shortened K were risk factors for the occurrence of DKD in patients with T2DM(P<0.05).The results of the ROC curve analysis showed that the area under the curve(AUC)of the combined prediction of the 4 indicators was 0.882,which was larger than that of the separate detections of serum Hcy,K,Angel,and MA(Z=2.020,2.809,2.989,2.361;P=0.043,0.005,0.003,0.018).Conclusion In patients with DKD,the level of K is significantly shortened,while the levels of Angle,MA,and serum Hcy are significantly elevated,which are closely related to the progression of the pa-tients'diseases.The combined detection of the TEG related parameters K,Angle,and MA in TEG and serum Hcy have potential clinical value in the prediction of DKD in patients with T2DM.关键词
2型糖尿病/糖尿病肾病/同型半胱氨酸/血栓弹力图/尿清蛋白与肌酐比值Key words
type 2 diabetes mellitus/diabetic kidney disease/homocysteine/thromboelastogram/urine albumin to creatinine ratio分类
临床医学引用本文复制引用
应子薇,周广举..TEG相关参数联合血清Hcy在2型糖尿病肾脏病变中的应用价值[J].检验医学与临床,2025,22(8):1100-1105,6.基金项目
四川省基层卫生事业发展研究中心科研创新项目(SWFZ23-W-01). （SWFZ23-W-01）
