2型糖尿病患者血纤维蛋白原与下肢血管病变的关系

Relationship of the levels of fibrinogen in type 2 diabetes mellitus with lower extremity arterial disease

目的探讨2型糖尿病患者下肢血管病变与纤维蛋白原水平的关系。方法用高分辨率彩色多谱勒超声对103例2型糖尿病患者下肢血管进行检测,同时测定血纤维蛋白原、血脂、血糖、糖化血红蛋白,分析上述指标与糖尿病下肢血管不同程度病变的关系。结果下肢血管病变组的纤维蛋白原、年龄均显著大于无病变组(P<0.01),且在重度病变组二者均显著大于轻中度病变组(P<0.01);病程在下肢血管病变组大于无病变组(P<0.05),轻中度病变组与重度病变组间无显著性差异(P>0.05);重度病变组的低密度脂蛋白胆固醇(LDL-C)均大于无病变组和轻中度病变组(P<0.05),而后两组间LDL-C无显著性差异(P>0.05);糖尿病高纤维蛋白原组较正常纤维蛋白原组动脉硬化发生率更高,病变程度更重(P<0.05)。结论2型糖尿病患者血纤维蛋白原水平升高与下肢血管病变的发生、发展密切相关,故治疗时除降糖、降脂外,应积极控制血纤维蛋白原水平。

Objective To study the relationship between fibrinogen and lower extremity artenal disease（LEAD） in type 2 diabetic patients. Methods Lower extremities of 103 patients with type 2 diabetes were detected by high resolution color Doppler ultrasonography, and the levels of/ibrinogen, fasting blood glucose ,glycosylated hemoglobin and serum lipid were examined, which were applied to anylazed the relationship with diversity process of lower extremity arterial disease. Results The fibrinogen, age, duration in lower extremitiy arterial disease group was significantly higher than those without LEADgroup （ respectively P 〈 0.01, 〈0.01, 〈0.05 ）. The fibrinogen,age in severe LEAD group were significantly higher than those in mild and middle group（ respectively P 〈0.01, 〈0.01 ）. The LDL-C in severe LEAD group was higher than those in the other two groups（ respectively P 〈0.05, 〈0.05）. The morbidity of LEAD in high level fibrinogen diabetes group was also increased than that in normal fibrinogen group, and the process severity advanced. Conclusions The higher levels of fibrinogen in type 2 diabetes meUitus was closely related with the occurence and severity of lower extremity arterial disease. So in addition to effective control of hyperglycosemia and hyperlipidemia,we should also actively control the level of fibrinogen.