血栓前体蛋白和抗凝血酶-Ⅲ在糖尿病微血管病变患者中的检测及临床意义

The detection and clinical significance of thrombus precursor protein and antithrombin Ⅲ in patients with diabetic microangiopathy

目的探讨血栓前体蛋白(TpP)和抗凝血酶-Ⅲ(AT-Ⅲ)在糖尿病微血管病变(DM)患者中的检测及临床意义。方法选取2013年4月至2015年4月治疗的DM患者94例作为研究组,另选同期进行体检健康者50例作为健康对照组。检测并记录各组纤维蛋白原(FIB)、D-二聚体(D-D)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血糖、血脂和同型半胱氨酸(Hcy),糖化血红蛋白(HbA1c)、TpP浓度和AT-Ⅲ活性。结果研究组空腹血糖(FPG)、餐后2 h血糖(2 hPG)、HbA1c、甘油三酰(TG)、总胆固醇(TC)、TpP显著高于健康对照组[(6.93±0.94 mmol/L)vs.(5.27±0.44 mmol/L)、(9.11±1.09 mmol/L)vs.(6.09±0.55 mmol/L)、(7.79%±1.04%)vs.(5.49%±0.33%)、(1.89±1.07 mmol/L)vs(1.48±0.77 mmol/L)、(4.49±1.28 mmol/L)vs.(4.09±0.91 mmol/L)、(5.48±2.92μg/ml)vs.(3.78±1.21μg/ml)],AT-Ⅲ活性显著低于健康对照组[(91.58±12.54)vs.(102.84±11.63)%],差异具有统计学意义(均P<0.05)。结论 DM患者TpP浓度升高,AT-Ⅲ浓度下降,存在血栓形成风险,对DM患者进行血浆TpP浓度和AT-Ⅲ活性联合检测,对血栓性疾病的早期发现及治疗具有积极意义。

Objective To explore the the detection and clinical significance of thrombus precursor protein and antithrombin Ⅲ in patients with diabetic microangiopathy.Methods 94 patients with diabetic microangiopathy were selected from Apr 2013 to Apr 2015 as the study group,during the same period,50 healthy subjects in the hospital were enrolled as healthy control group,the FIB,D-D,PT,APTT,blood glucose,blood lipid,Hcy,Hb A1 c,TpP concentration and AT-Ⅲ activity in each group were detected and recorded.Results Compared with the healthy control group,the FPG,2 hPG,HbA1c,TG,TC,TpP concentration of research group were higher [（6.93 ± 0.94 mmol/L） vs.（5.27 ± 0.44mmol/L）,（9.11 ± 1.09 mmol/L） vs.（6.09 ± 0.55 mmol/L）,（7.79% ± 1.04%） vs.（5.49% ± 0.33%）,（1.89 ± 1.07 mmol/L） vs.（1.48 ± 0.77 mmol/L,（4.49 ± 1.28 mmol/L） vs.（4.09 ± 0.91 mmol/L）,（5.48 ± 2.92 μg/ml） vs.（3.78 ± 1.21 μg/ml） ],and the activity of AT-Ⅲwas lower [（91.58 ± 12.54） vs.（102.84 ± 11.63） % ],and the differences were statistically significant（all P〈0.05）.Conclusion There is risk of thrombosis in patients with DM,combined detection of plasma TpP concentration and AT-Ⅲ activity in patients with DM has positive significance for early diagnosis and treatment.