非胰岛素依赖型糖尿病患者血浆D-二聚体的变化及其意义

THE CHANGE OF PLASMA DDIMER LEVELS AND ITS SIGNIFICANCE IN NIDDM CASES

为探讨非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者凝血及纤溶活性，采用ＥＬＩＳＡ双抗体夹心法测定了３５例ＮＩＤＤＭ患者的血浆Ｄ－二聚体。结果：ＮＩＤＤＭ患者血浆Ｄ－二聚体水平为１．６３ｍｇ／Ｌ±０．１４ｍｇ／Ｌ），明显高于正常对照组（０．３３ｍｇ／Ｌ±０．０９ｍｇ／Ｌ）（Ｐ＜０．０５）；有血管病变组Ｄ－二聚体为２．６２ｍｇ／Ｌ±０．６８ｍｇ／Ｌ，高于无血管病变组（０．６９ｍｇ／Ｌ±０．６８ｍｇ／Ｌ），差异有显著性（Ｐ＜０．００１）；血浆Ｄ－二聚体与ＦＢＧ、ＴＣ、ＴＧ相关分析表明Ｄ－二聚体与ＦＢＧ、ＴＧ呈正相关（分别为ｒ＝０．５８，Ｐ＜０．００１；ｒ＝０．０３５，Ｐ＞０．２；ｎ＝１４），与ＴＣ呈负相关（ｒ＝－０．０４５，Ｐ＞０．２，ｎ＝１４）。８例ＮＩＤＤＭ患者治疗后血浆Ｄ－二聚体较治疗前显著降低，分别为１．１１±０．８１，３．６５±１．２２，Ｐ＜０．０５）。提示ＮＩＤＤＭ患者体内存在高凝和继发纤溶活性亢进，血浆Ｄ－二聚体是反映ＮＩＤＤＭ患者高凝和缺血性疾病的诊断、疗效观察的良好指标。

In order to investigate the NIDDM patients coagulability as well as fibrinolysis,we measured thirtyfive NIDDM patients′ plasma concentration of Ddimer by a sandwichELISA assay with two selfmade McAbs.Result:The average concentration of Ddimer is 1.63mg/L±0.14mg/L.It is higer than that of healthy man(which is 0.33mg/L±0.09mg/L)(P<005).Patients with vascular disease have a higher level of Ddimer than patients without vascular disease,they are 2.62mg/L±0.68mg/L and 0.69mg/L±0.68mg/L;there is a significant discrepancy between the two groups (P<0001).The analysis of relationship between the plasma concentration of Ddimer and FBG,TC,TG,showed that Ddimer is strongly related to FBG and TG(they are r=0.58,P<0.0001;r=0.035,P>0.2,n=14).However,Ddimer is inversely related to TC(r=-0.0045,P>0.2,n=14).Eight patients′ Ddimer greatly decreased after the treatment,becoming 1.11±0.81,3.65±1.22,P<0.05.This article provides evidence that in NIDDM patients,bodies there exist high coagulation and successive accentuation of fibrinolysis.For the diagnosis and therapeutic effect on patients with high coagulation and ischemic disease the plasma level of Ddimer is a fairly good index.