冠心病并发Ⅱ型糖尿病患者高凝状态的临床研究

Clinical study of hypercoagulation in coronary disease patients with noninsulin dependent diabetes mellitus

目的探讨冠心病(CHD)并发非胰岛素依赖糖尿病(NIDDM)患者体内凝血功能的变化及临床意义。方法选择病例组CHD并发NIDDM患者24例,CHD患者32例,以及正常对照组20例,分别测定血浆D-二聚体(D-D im er)、纤维蛋白原(Fbg)含量,同时分析Fbg与冠脉病变支数的相关性。结果CHD并发NIDDM患者血浆D-D im er、Fbg水平显著高于CHD患者和正常对照者(P<0.05或P<0.01),并且CHD患者也显著高于对照者(P<0.05);冠脉病变严重者血浆Fbg含量显著高于冠脉病变较轻患者(P<0.01)。结论CHD并发NIDDM患者体内存在明显的高凝状态,并与冠状动脉病变程度有关。

AIM To explore the coagulation and its clinical significance in coronary heart disease （CHD） patients with non-insulin dependent diabetic mellitus （NIDDM）. METHODS Twenty-four CHD patients with NIDDM were chosen in CHD ＋ NIDDM group, 32 CHD patients in CHD group and 20 normal cases in control group. The levels of plasma D-Dimer and fibrinogen （Fbg） were respectively measured and the correlations of Fbg to the number of diseased coronary arteries were also analyzed. RESULTS Compared with those in the normal cases and patients with CHD, the levels of D-Dimner and Fbg were significantly elevated in CHD patients with NIDDM, though the levels were significantly elevated in CHD patients compared with those in normal cases. The plasma levels of Fbg in patients with serious pathogenesis of coronary arteries were much higher than those in patients with mild pathogenesis of coronary arteries. CONCLUSION The CHD patients with NIDDM have higher coagulation, indicating it is of significance in the pathogenesis of coronary arteries.