糖尿病患者凝血状态及影响因素研究

Blood coagulation and its influcing factors in diabetes mellitus patients

目的观察糖尿病患者与非糖尿病患者的凝血状态差异及其影响因素,为临床治疗糖尿病合并凝血功能异常提供参考。方法选择糖尿病患者251例(糖尿病组),糖尿病组又根据是否有大血管病变分为大血管病变组163例,无大血管病变组88例,另选择健康体检者80例(对照组),观察其凝血酶时间(TT)、活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(Fib)的差异。结果糖尿病组TT[(16.28±1.44)s vs(17.80±0.97)s]、APTT[(35.57±3.73)s vs(37.46±4.17)s]、PT[(12.60±1.08)s vs(13.84±0.60)s]较对照组明显缩短,Fib[(3.21±0.87)g/L vs(2.91±0.55)g/L]较对照组明显增高(P<0.05,P<0.01)。大血管病变组Fib较无大血管病变组明显升高(P=0.03)。糖尿病组主要影响凝血指标的是糖化血红蛋白、TC、LDL-C。结论糖尿病患者存在凝血系统的异常,糖化血红蛋白、TC、LDL-C水平与凝血指标具有明显的相关性。

Objective To study the blood coagulation and its influencing factors in diabetes mellitus（DM）patients and non-DM patients.Methods Two hundred and fifty-one DM patients served as a DM group and were further divided into great vessel lesion group（n=163）and non-great vessel lesion group（n=88）.Eighty subjects undergoing physical examination served as a control group.Their TT,APTT,and PT were recorded and their serum Fib level was measured.Results The TT,APTT,and PT were significantly shorter and the serum Fib level was significantly higher in DM group than in control group（16.28±1.44svs17.80±0.97 s,35.57±3.73svs37.46±4.17 s,12.60±1.08 svs 13.84±0.60 s,3.21±0.87g/L vs 2.91±0.55g/L,P〈0.05,P〈0.01）.The serum levels of HbA1 c,TC and LDL-C were the major influencing factors for blood coagulation in DM patients.Great vessel lesion was related with the elevated serum Fib level.Conclusion The abnormal blood coagulation is closely related with the serum levels of HbA1 c,TC,and LDL-C in DM patients.