2型糖尿病患者血栓分子标志物的检测及临床意义

Clinical significance of molecular markers for thrombus detection in patients with type 2 diabetes

目的探讨320例糖尿病患者血液中血小板聚集率(PAGT:MAR)、血浆凝血酶原时间(PT)、超敏C反应蛋白(CRP)的变化及临床意义。方法血小板聚集率(PAGT:MAR,用ADP做诱导剂)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)采用血液凝聚仪定量测定,组织型纤溶酶原激活剂(t-PA)、血管性血友病因子(vWF)采用酶标仪应用酶联免疫法检测,超敏C反应蛋白(CRP)采用生化分析仪用透射免疫比浊法测定,结果与160例健康对照组比较。结果糖尿病患者PAGT:MAR、FIB、vWF、CRP水平均显著高于对照组(P<0.01);t-PA、PT、APTT和TT水平显著低于对照组(P<0.01),且糖尿病并发血管病变组与无血管病变组相比,MAR、FIB、vWF、CRP水平增高且t-PA水平降低,差异具有显著性(P<0.01);糖尿病并发血管病变组PT、APTT、TT水平显著低于对照组(P<0.01)。结论糖尿病患者存在血栓前状态,联合检测上述分子对糖尿病及其并发症的诊断、治疗和病情观察均有重要的临床意义。

Objective To observe the change of platelet agglutination test：maximal aggregation ratio（PAGT：MAR）,prothrombin time（PT）,Acute-Phase Proteins and high sensitivity C-reactive protein（hs-CRP）in the blood of 320 cases of diabetes.Methods PAGT：MAR,PT,APTT,TT and FIB were quantitative determined with hema tracer.T-PA and vWF were euzymelinked immunosorbent determined with microplate reade.Hs-CRP was determined with biochemistry analyzer by transmission Immunoturbidimetry.Results from the type 2 diabetes group were compared with results from the healthy controls.Results PAGT：MAR、FIB、vWF and CRP values in the patients with diabetes were significantly higher than those in the healthy control groups（P0.01）,however t-PA、APTT and TT values in the diabetic patients were significantly lower than those in the healthy controls（P0.01）.PAGT：MAR、FIB、vWF and CRP values in the patients of diabetic group with diabetic angiopathy were statistically higher than those in the diabetic group without angiopathy and t-PA was lower.PT、APTT and TT values in the group with diabetic angiopathy were significantly lower than those in the healthy controls（P0.01）.Conclusion The prothrombotic state is observed in patients with type 2 diabetes.Joint detect molecular markers mentioned above has important clinical significance in the diagnosis treatment and disease observation of diabetes and its complications.