糖尿病视网膜病变患者血浆D-二聚体和纤维蛋白原临床观察

Clinical study on plasma D-dimer and fibrinogen in patients with diabetic retinopathy

目的探讨D-二聚体（D-D）和纤维蛋白原（FIB）在不同程度糖尿病视网膜病变（DR）中的意义。方法临床病例对照研究。对2012年10月至2014年10月在保定市第一中心医院就诊糖尿病视网膜病变患者42例（84只眼），根据眼底血管造影结果划分成非增殖期组25例（50只眼）A组及增殖期组17例（34只眼）B组，同期糖尿病无视网膜病变患者20例（40只眼）C组，排除糖尿病的健康体检者20例（40只眼）D组，分别进行血浆D-二聚体（D—D）和纤维蛋白原（FIB）的测量并比较。结果D—D平均值A组为（1．15±0．64）mg／L，B组为（1．47±0．39）mg／L，C组为（0．37±0．17）mg／L，D组为（0．31±0．13）mg／L，A组及B组明显高于C组及D组，B组明显高于A组，各组间差异均有统计学意义（P〈0．05）。但C组与D组差异无统计学意义（P〉0．05）。FIB平均值A组为（4．44±0．64）g／L，B组为（4．51±1．27）g／L，C组为（3．12±0．52）g／L，D组为（2．97±0．61）g／L，A组及B组明显高于C组及D组，各组间差异均有统计学意义（P〈0．05）。但A组与B组差异无统计学意义，（P〉0．05）C组与D组差异无统计学意义（P〉0．05）。结论D-二聚体（D—D）和纤维蛋白原（FIB）的检测在监测糖尿病视网膜病变的发生及预后判断方面具有意义。

Objective To investigate the difference of plasma D-dimer and fibrinogen in the varying degrees of patients with diabetic retinopathy. Methods Sixty-two diabetic patients were divid- ed into three groups： 25 patients in simple diabetic retinopathy （SDR） group （group A）, 17 patients in proliferative diabetic retinopathy （PDR） group （group B）, 20 patients in no diabetic retinopathy （NDR） group （group C）; 20 normal persons were recruited as the control group （group D）. The plas- ma D-dimer and fibrinogen were examined. Results The mean value of D-D in Group A was 1.15±0.64mg/1, Group B 1.47±0.39mg/1, Group C 0.37±0.17mg/1, and Group D 0.31±0.13mg/1. The mean value of FIB in Group A was 4.44±0.64 g/l, Group B 4.51±1.27 g/l, Group C 3.12±0.52 g/l, and Group D 2.97±0.61 g/1. The difference of D-D among the four groups was significant （P 〈0.05）, the difference of FIB among the four groups was significant （P 〈0.05）. Conclusions The plasma D-D of the patients in diabetic retinopathy is higher than that of the patients in no diabetic retinopathy and normal persons. The plasma FIB of the patients in diabetic retinopathy is higher than that of the patients in no diabetic retinopathy and normal persons.