纤维蛋白原与老年2型糖尿病大血管并发症相关因素的关系

Relationship between fibrinogen and relative factors of macroangiopathy in elder patients with type 2 diabetes mellitus

目的探讨老年2型糖尿病（DM）患者血浆纤维蛋白原（FIB）的变化及其与大血管并发症的关系。方法103例老年DM患者根据FIB水平的不同，分为正常FIB组（Ⅰ组）和高FIB组（Ⅱ组），比较两组的年龄、病程、糖基化血红蛋白（HbA1C）、空腹血浆胆固醇（CH）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、极低密度脂蛋白（VLDL）、空腹血糖（FPG）、空腹胰岛素（Fins）及胰岛素敏感指数（ISI）。同时检查下肢血管彩超和头颅CT或MRI。结果与Ⅰ组相比，Ⅱ组年龄大、女性构成比高、病程长、HbA1C水平高、大血管并发症发生率高（P〈0．01～0．05）。回归分析显示，FIB与LDL、年龄、HbA1C呈正相关，与ISI呈负相关。结论随着年龄的增长，DM病程延长，长期血糖、血脂控制不良及胰岛素抵抗，老年2型DM患者FIB明显上升，大血管并发症的危险性增加。

Objective To investigate changes of plasma fibrinogen （FIB） in elder patients with type 2 diabetes mellitus （DM）, and the relationship of FIB with macroangiopathy. Methods 103 senile type 2 diabetic patients were divided into normal FIB group （group Ⅰ ） and high FIB group（group Ⅱ ） according to the level of FIB. HbA1C fasting plasma cholesterol （ CH ）, triglyceride （ TG ）, high density lipoprotein （ HDL ）, low-density-lipoprotein （ LDL）, very-low-density-lipoprotein（ VLDL）, FIB, fasting plasma glucose and insulin （ FPG and FIB）, insulinsensitivity index （ISI） of the two groups were compared. Meanwhile, lower extremitial arteries were detected by color Doppler uhrasonography and cerebral imagings were obtained by CT, or MRI. Results Compared with group Ⅰ , group Ⅱ patients presented older age, higher ratio of female, longer diabetic course, higher HbA1C level and higher incidence of macroangiopathy. Multiple regression analysis shows that FIB was positively correlated with LDL,age and HbA1C, and was negatively correlated with ISI. Conclusion The risk of macroangiopathy and the FIB level increase significantly in senile type 2 diabetic patients with the increase of age and diabetic course, bad control of blood sugar and lipids as well as insulin resistance.