糖尿病患者白细胞组织因子促凝血活性的改变及意义

Change and significance of TF-PCA in diabetic patients

目的:观察糖尿病患者血循环中细胞组织因子促凝血活性(TF-PCA)和血浆中同型半胱氨酸(Hcy)变化,探讨糖尿病血管并发症的发病机制。方法:TF-PCA采用内毒素刺激全血凝固法(TiFaCT法),Hcy采用生化法。结果:测得糖尿病无血管并发症患者TF-PCA为50.3±29.6TF-PCA△s,血浆Hcy浓度为(11.89±6.39)μmol/L,伴有血管病变患者TF-PCA为82.3±33.8TF-PCA△s,血浆Hcy浓度为(25.10±7.84)μmol/L,均较正常对照组显著增高,而且伴血管病变患者的增高更为明显,TF-PCA和Hcy的改变有显著的相关性。结论:糖尿病患者全血TF-PCA增强提示存在血栓前状态,血浆Hcy浓度的增高提示糖尿病患者有不同程度的血管损伤,对TF-PCA和Hcy的监测有利于糖尿病并发症血管病变的防治。

Objective：To observe the change of tissue factor procoagulant activity（TF-PCA） and homocysteine（Hcy） in diabetic patients and explore the mechanism of complication associated with diabetes.Method：TF-PCA and Hcy was tested by Tissue Factor Clotting Time（TiFaCT）and biochemical method,respectively.Result：TF-PCA and Hcy were significantly higher in diabetic patients than those in health adults,and a more obviously rise in patients with vascular complication.They were（82.3 ±33.8）△s and（25.10±7.84）μmol/L respectively;while（50.3 ±29.6）△s and（11.89±6.39）μmol/L in patients without vascular complications.There was a correlation between TF-PCA and Hcy.Conclusion：The increase of TF-PCA suggested pre-thrombotic state and the rise of Hcy may be a sign of different severity of blood vessel injury.Diabetic patients would benefit from monitoring TF-PCA and Hcy for vascular complication prophylaxis and treatment.