H型高血压合并2型糖尿病患者血小板活性和凝血功能变化及其临床意义

Changes of platelet activity and coagulation function in patients with type H hypertension complicated with type 2 diabetes and its clinical significance

目的探讨H型高血压合并2型糖尿病患者血小板活性和凝血功能变化及其临床意义。方法 2015年4月至2017年11月从海南省人民医院门诊及住院患者中选取165例H型高血压患者,根据2型糖尿病诊断标准分为H型高血压合并2型糖尿病组(A组)80例和单纯H型高血压组(B组)85例,比较两组患者的血小板活性和凝血功能的变化情况。结果 A组和B组患者的血浆中血栓素(TXB2)[(135.6±31.6)pg/mL vs(102.6±30.3)pg/mL]、血小板颗粒膜蛋白-140(GMP-140)[(18±6)μg/L vs(13±4)μg/L]、血小板活化因子CD62p活性[(14.63±5.62)%vs(8.41±4.71)%]、凝血酶原时间(PT)[(7.6±0.5)s vs(12.2±0.4)s]、部分凝血活酶时间(APTT)[(27±3)s vs(31±4)s]、血浆纤维蛋白原(Fbg)[(7.4±2.3)g/L vs(5.3±2.1)g/L]、血浆组织型纤溶酶原激活剂(t-PA)[(0.34±0.07)IU/mL vs(0.22±0.08)IU/mL]、D-二聚体(D-Dimer)[(0.98±0.28)mg/L vs(0.61±0.24)mg/L]及血栓调节蛋白(TM)[(25.7±3.7)μg/L vs(19.4±3.5)μg/L]水平比较差异均有统计学意义(P<0.05)。结论 H型高血压合并2型糖尿病患者存在明显血小板活性和凝血功能变化,这可能与H型高血压合并2型糖尿病患者更易出现心脑血管事件有关,应采取措施积极干预。

Objective To evaluate the changes of platelet activity and coagulation function in patients with type H hypertension complicated with type 2 diabetes and its clinical significance. Methods A total of 165 patients with type H hypertension admmited in outpatient and inpatients Department, Hainan General Hospital from April 2015 to November 2017 were selected. According to the diagnostic criteria of type 2 diabetes mellitus, they were divided into type H hypertension complicated with type 2 diabetes mellitus（group A, n=80） and only type H hypertension group（group B, n=85）. The changes of platelet activity and coagulation function were compared between the two groups.Results The levels of thromboxane B2（TXB2）, platelet granule membrane protein-140（GMP-140）, platelet activating factor CD62 p activity, prothrombin time（PT）, activated partial thromboplastin time（APTT）, plasma fibrinogen（Fbg）, plasma tissue plasminogen activator（t-PA）, D-Dimer, thrombomodulin（TM） in plasma of patients in group A were（135.6±31.6） pg/mL,（18±6） μg/L,（14.63±5.62）%,（7.6±0.5） s,（27±3） s,（7.4±2.3） g/L,（0.34±0.07） IU/mL,（0.98±0.28） mg/L,（25.7±3.7） μg/L, respectively, which were significantly higher than（102.6±30.3） pg/mL,（13±4） μg/L,（8.41±4.71）%,（12.2±0.4） s,（31±4） s,（5.3±2.1） g/L,（0.22±0.08） IU/mL,（0.61±0.24） mg/L,（19.4±3.5） μg/L of group B（P〈0.05）. Conclusion Platelet activity and coagulation function have significant changes for patients with type H hypertension complicated with type 2 diabetes mellitus, which may be related to the occurrence of cardio-cerebrovascular events in patients with type H hypertension and type 2 diabetes mellitus. Measures should be taken to intervene actively to control type H hypertension and type 2 diabetes mellitus.