2型糖尿病患者凝血变化的试验分析

Study on the coagulation changes in type 2 diabetes patients

目的 观察 2型糖尿病患者凝血指标的变化及其临床意义。方法 利用双抗体夹心ELISA法检测 6 5例 2型糖尿病患者 (其中 33例合并血管病变 )及 38名健康对照者血浆血管性假性血友病因子抗原 (vWF :Ag)、凝血酶调节蛋白 (TM)、凝血酶原片段 (F1+ 2 )、血小板选择素 (P selectin)水平。结果 糖尿病组血浆vWF :Ag (14 7.3± 2 9.5 ) %、TM (2 9.9± 11.3) μg/L、F1+ 2 (0 .78± 0 .19)nmol/L、P selectin (16 .9± 3.2 ) μg/L水平均显著高于健康对照组 ,差异有显著意义 (P <0 .0 5～ 0 .0 1) ;有血管病变的患者血浆vWF :Ag (16 1.6± 34.2 ) %、TM (32 .9± 13.2 ) μg/L、F1+ 2 (0 .96± 0 .2 5 )nmol/L、P selectin(19.2± 3.4 ) μg/L水平均显著高于无血管病变组 ,差异有显著意义 (P <0 .0 5～ 0 .0 1) ;相关分析显示 ,F1+ 2 、P selectin与vWF :Ag显著正相关 (r分别为 0 .4 2 3、0 .397,P均 <0 .0 1) ,F1+ 2 、P selectin与TM亦显著正相关 (r分别为 0 .4 5 8、0 .4 11,P均 <0 .0 1)。结论 2型糖尿病患者均存在血管内皮损伤 ,并由此引起血小板活化和血液的高凝状态 ;血浆vWF :Ag、TM、F1+ 2 、P selectin水平在一定程度上可反映 2型糖尿病患者血管病变的情况。

Objective To investigate the variation of coagulation markers and its clinical value in type 2 diabetes patients. Methods The plasma levels of von Willebrand factor: antigen (vWF: Ag), thrombomodulin (TM), prothrombin fragment 1+2 (F 1+2 ) and P selectin were measured by ELISA in 65 patients with type 2 diabetes (including 33 patients with vascular complication) and 38 healthy people. Results The plasma level of vWF:Ag, TM, F 1+2 and P selectin in group of type 2 diabetes were significantly higher than that of normal controls ( P <0.05～0.01);The plasma level of these markers in group of type 2 diabetes with vascular complication were higher than that without vascular complication ( P <0.05～0.01); Plasma levels of F 1+2 and P selectin are correlated with those of vWF and TM ( P <0.01). Conclusions Type 2 diabetes patients usually exist vascular endothelial injury, platelet activation and hypercoagulability. The plasma level of vWF: Ag, TM, F 1+2 and P selectin may reflect vascular pathological changes in type 2 diabetes patients to a certain extent.