血小板参数及活化标志物与2型糖尿病患者颈动脉内膜中层厚度的相关性

Correlation of platelet parameters and activation markers with carotid artery intima media thick-ness in patients with type 2 diabetes mellitus

目的：探讨血小板参数及活化标志物与2型糖尿病患者颈动脉内膜中层厚度（CIMT）的相关性。方法收集2型糖尿病住院患者共195例，根据颈动脉内膜中层厚度分为无病变组60例、CIMT 增厚组50例及斑块组85例，测定三组患者血小板计数（PLT）、平均血小板体积（MPV）、血小板分布宽度（ PDW）、血小板容积（PCT）、空腹血糖（GLU）、总胆固醇（TC）等指标及尿液11-脱氢血栓素 B2（11-DH-TXB2）的含量，并进行统计学分析。结果①斑块组患者病程、低密度脂蛋白胆固醇（LDL-C）、MPV、PDW、11-DH-TXB2水平高于无病变组及 CIMT增厚组，差异有统计学意义（P 〈0.05）；②CIMT 增厚组患者病程、LDL-C、MPV、PDW、11-DH-TXB2水平高于无病变组，差异有统计学意义（ P 〈0.05）；③Spearman 相关分析显示，CIMT 与年龄、病程、BMI、GLU、糖化血红蛋白（GHbA1c）、LDL-C、MPV、PDW 及11-DH-TXB2水平呈正相关，与 HDL-C、PLT 水平呈负相关（P 〈0.05）；④Logistic回归分析显示 MPV、PDW 和11-DH-TXB2是2型糖尿病患者 CIMT 异常的危险因素。结论血小板参数（MPV、PDW）及活化标志物（尿11-DH-TXB2）与2型糖尿病患者颈动脉内膜中层厚度具有相关性。

Objective To observe the correlation between platelet parameters,platelet activa-tion marker and carotid intima-media thickness（ CIMT）in patients with type 2 diabetes mellitus. Methods One hundred and ninety-five type 2 diabetic patients were enrolled in the study. The patients were divided into normal group,CIMT increased group and clot group according to the carotid intima-media thickness. The levels of platelet count（PLT）,mean platelet volume（MPV）,platelet distribution width（PDW）,platelet hematocrit（ PCT）,urinary 11-dehydro-thromboxane B2（11-DH-TXB2 ）and＆amp;nbsp;other clinical,biochemical characteristics were measured. The results were statistically analyzed. Results ①The levels of serum LDL-C,MPV,PDW,urinary 11-DH-TXB2 and clinical course in the clot group were higher than those in the CIMT increased group and normal group（P 〈 0. 05）. ②Com-pared with normal group,clinical course,serum LDL-C,MPV,PDW and urinary 11-DH-TXB2 were higher in the CIMT increased group（P 〈 0. 05）. ③With spearman rank correlation test,carotid intima-media thickness was positively associated with age,course,BMI,GLU,GHbA1c,LDL-C,MPV,PDW and urinary 11-DH-TXB2 ,whereas carotid intima-media thickness was negative associated with HDL-C, PLT（all P 〈 0. 05）. ④ MPV,PDW and urinary 11-DH-TXB2 were shown as the independent risk factors of CIMT on Logistic regression analysis. Conclusions Platelet activation marker and platelet parameters are associated with carotid intima-media thickness in patients with type 2 diabetes mellitus.