不同糖化血红蛋白水平的2型糖尿病患者血液流变学检测分析

Analysis of hemorheology in type 2 diabetes patients of different glycosylated hemoglobin level

目的分析糖化血红蛋白(GHbA1c)控制在不同水平的2型糖尿病患者血液流变学的特点,为其治疗及预防提供参考依据。方法选取2型糖尿病病例113例,按GHbA1c不同水平分为:A组(33例,控制良好)、B组(40例,控制一般)、C组(40例,控制不佳)。同时随机抽取健康体检者40例作为对照(D组)。分别检测GHbA1c、血液流变学及生化指标,并进行分析对比。结果单因素方差分析显示,血流变相关指标除血细胞比容在四组之间无统计学意义外(F=0.08,P=0.970),其他指标在四组之间均存在统计学差异(P<0.05);采用LSD-t检验方法分析结果:血流变指标除血细胞比容外A、B、C组均明显高于D组(P<0.05);采用S-N-K检验方法进行组间分析:除全血高切、中切黏度、血沉方程K值A、C组比较,差异无统计学意义(P>0.05);血浆黏度、RBC刚性指数A、D组间比较,差异无统计学意义(P>0.05);RBC变形指数及三酰甘油B、C组间比较,差异无统计学意义(P>0.05),余下各指标不同组之间的比较差异均有统计学意义(P<0.05)。结论 2型糖尿病患者存在血液流变学指标异常,不同GHbA1c水平下血液流变学指标有差异。

Objective To analyze the hemorheology of patients with type 1I diabetes in different glycosylated hemoglobin levels. Methods According to different levels of GHbAlc 116 patients with 2 diabetes were divided into good control A group of 33 cases, general control B group of 40 cases,and poor control C group of 40 cases from May 2010 to May 2012 in our community. At the same time healthy subjects were selected randomly as control D group of 40 cases. Hemorheology, GHbAlc and biochemical indexes were determined and analyzed. Results There were significant differences between the four groups in other index （P〈0.05） ex- cept hematoerit in hetween the four groups （F= 0.08, P = 0. 970）. The blood theological indexes except hematocrit were signifi- cantly higher than those in group D. Groups difference were analyzed with S-N-K test method and the results showed that there were no significant differences between A and C groups in whole blood high shear viscosity and moderate shear viseosity（P = 0. 345 ,P=O. 329）. So was that of ESR equation K value （P=0. 810）. No significant difference has been found between groups A and D in plasma viscosity and RBC rigidity index （P = 0. 396, P = 0. 507）. The remaining indexes were different between groups each other （P〈0.05）. Conclusion There are abnormal hemorheology indices in patients with type 2 diabetes mellitus and blood rheology index of different glycosylated hemoglobin levels are different.