2型糖尿病微血管病变患者同型半胱氨酸与凝血指标的相关性及临床分析

Correlation and Clinical Analysis of Homocysteine and Coagulation Indexes in Patients with Type 2 Diabetic Microangiopathy

目的解读2型糖尿病微血管病变(DMAP)患者同型半胱氨酸(Hcy)和凝血指标之间的关系,进而为该病临床治疗提供更科学、有效的指导。方法选择2019年8月—2020年8月收治的128例T2DM患者,甲组64例是没有发生微血管病变者,乙组64例是微血管病变者,取同期64名体检健康的志愿者(丙组),对以上3组进行化学检验,对比检测结果,分析不同指标的关系,总结引发微血管病变的风险因素。结果乙组Hcy、Fbg、D-Dimer水平明显高于甲、丙组,乙组PT、TT、APTT明显低于甲、丙组,差异有统计学意义(P<0.05);Hcy水平与PT、TT、APTT、D-Dimer之间没有显著相关性,但是和Fbg之间存在明显的正相关性(r=0.222,P<0.05)。Logistic回归发现Hcy是引起2型DMAP者发生微血管病变的独立风险因素。结论高Hcy水平参与DMAP过程,发挥重要作用,严重的凝血与纤溶功能异常是DMAP患者的主要表现。

Objective To interpret the relationship between homocysteine(Hcy)and coagulation indicators in patients with type 2 diabetic microangiopathy(DMAP),and to provide more scientific and effective guidance for the clinical treatment of this disease.Methods 128 patients with T2DM admitted from August 2019 to August 2020 were selected.64 patients in group A had no microvascular disease,64 patients in group B had microvascular disease,and 64 healthy volunteers(group C)during the same period were selected.The group performed chemical tests,compared the test results,analyzed the relationship between different indicators,and summarized the risk factors for microvascular disease.Results The levels of Hcy,Fbg and D-Dimer in group B were significantly higher than those in groups A and C.The PT,TT,and APTT in group B were significantly lower than those in groups A and C.The differences were statistically significant(P<0.05);There was no significant correlation between PT,TT,APTT,and D-Dimer,but there was a significant positive correlation with Fbg(r=0.222,P<0.05).Logistic regression found that Hcy was an independent risk factor for microangiopathy in patients with type 2 DMAP.Conclusion High Hcy levels are involved in the DMAP process and play an important role.Severe coagulation and fibrinolytic dysfunction are the main manifestations of DMAP patients.