Małyszko Jacek S, Małyszko Jolanta, Hryszko Tomasz, Myśliwiec Michał
Klinika Nefrologii i Transplantologii AM w Białymstoku.
Pol Arch Med Wewn. 2003 Aug;110(2):843-8.
Patients with end-stage renal disease dialyzed due to diabetic nephropathy are at higher risk of death due to cardiovascular complications than dialyzed non-diabetic patients. Disturbances in hemostasis may play a role in the vascular complications of diabetes mellitus. It has been postulated that TAFI-Thrombin Activatable Fibrinolysis Inhibitor, newly described glycoprotein, couples two opposite systems: coagulation and fibrinolysis. The aim of the work was to study TAFI concentration in hemodialyzed and peritoneally dialyzed diabetic and non-diabetic patients. We assessed: TAFI concentration, markers of ongoing coagulation: thrombin-antithrombin complexes, prothrombin fragments 1 + 2 (markers of TAFI activation), a marker of ongoing fibrinolysis: plasmin-antiplasmin complexes, a marker of TAFI cataliser to TAFIa-thrombomodulin using commercially available kits. All four groups studied did not differ in regard to fibrinogen, thrombomodulin, plasmin-antiplasmin complexes, and TAFI concentration. Both groups of dialyzed diabetic patients have higher concentration of markers of ongoing coagulation when compared to dialyzed non-diabetic patients. Hypercoagulable state observed in dialyzed diabetic patients may contribute to the higher cardiovascular mortality in these population.
因糖尿病肾病接受透析的终末期肾病患者,相较于接受透析的非糖尿病患者,因心血管并发症导致死亡的风险更高。止血功能紊乱可能在糖尿病的血管并发症中起作用。据推测,凝血酶激活的纤维蛋白溶解抑制因子(TAFI),一种新发现的糖蛋白,将两个相反的系统——凝血和纤维蛋白溶解联系起来。这项研究的目的是研究血液透析和腹膜透析的糖尿病及非糖尿病患者的TAFI浓度。我们评估了:TAFI浓度、凝血过程的标志物:凝血酶 - 抗凝血酶复合物、凝血酶原片段1 + 2(TAFI激活的标志物)、纤维蛋白溶解过程的标志物:纤溶酶 - 抗纤溶酶复合物,以及使用市售试剂盒检测TAFI催化物向TAFIa - 血栓调节蛋白转化的标志物。所研究的四组在纤维蛋白原、血栓调节蛋白、纤溶酶 - 抗纤溶酶复合物和TAFI浓度方面没有差异。与接受透析的非糖尿病患者相比,两组接受透析的糖尿病患者凝血过程标志物的浓度更高。在接受透析的糖尿病患者中观察到的高凝状态可能导致这些人群心血管死亡率更高。