2型糖尿病视网膜病变患者凝血功能及相关危险因素的临床分析

Clinical analysis of coagulation function and related risk factors in patients with type 2 diabetic retinopathy

目的分析2型糖尿病视网膜病变患者凝血功能及相关危险因素。方法选取2015年1月-2017年1月间我院收治的95例2型糖尿病视网膜病变患者,分为非增殖期视网膜病变(non-proliferative diabetic retinopathy,NPDR)组(50例)和增殖期视网膜病变(poliferative diabetic retinopathy,PDR)组(45例),随机选取同期就诊的50位健康人群作为健康对照组。检测并记录两组患者与健康对照组的血浆凝血酶原时间(plasma prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,FBG)、D-二聚体(D-dimer,D-D)、凝血酶时间(thrombin time,TT)、血糖(blood glucose,GLU)、甘油三酯(triglyceride,TG)、胆固醇(cholesterol,CHOL)、高密度脂蛋白(high density lipoprotein,HDL)、低密度脂蛋白(low density lipoprotein,LDL)、血压、病程。结果与健康对照组相比,NPDR组和PDR组患者凝血功能PT、APTT显著下降(P<0.05或P<0.01),FBG、D-D显著上升(P<0.05或P<0.01),TT水平变化无统计学意义(P>0.05)。与PDR组比较,NPDR组FBG、D-D显著上升(P<0.05)。危险因素方面,与健康对照组相比,NPDR组和PDR组患者的GLU、TG、CHOL、LDL、血压均显著上升(P<0.05或P<0.01),HDL显著下降(P<0.05或P<0.01)。与PDR组比较,NPDR组GLU、血压、病程显著上升(P<0.05)。Logistic多因素回归分析显示,FBG、D-D、病程、血糖、血压是2型糖尿病患者视网膜病变的独立危险因素。结论 2型糖尿病视网膜病变患者存在凝血功能异常,定期监测凝血功能、病程、血糖、血脂、血压,及时改善患者血液高凝状态,为临床早期治疗提供依据。

Objective To analyze the coagulation function and related risk factors of type2diabetic retinopathy.Methods From January2015to January2017,a total of95patients with type2diabetic retinopathy wereenrolled in this study:non-proliferative retinopathy(NPDR)group(n=50)and proliferative retinopathy(PDR)group(n=45).The levels of plasma prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FBG),D-dimer(DD),thrombin time(TT),blood glucose(GLU),triglyceride(TG),cholesterol(CHOL),low densitylipoprotein(LDL)and blood pressure and duration of diseasewere compared.Results Compared with the healthycontrol group,the levels of PT and APTT decreased significantly(P<0.05or P<0.01);the levels of FBG and D-Draised significantly(P<0.05or P<0.01);the level ofTT showed no significant difference in the NPDR group and thePDR group(P>0.05).Compared with the PDR group,the FBG and D-D of the NPDR group increased significantly(P<0.05).About the risk factors,compared with the healthy control group,the levels of blood GLU,TG,CHOL,LDL and blood pressure increased significantly(P<0.05or P<0.01);high density lipoprotein decreased significantly(P<0.05or P<0.01)in the NPDR group and the PDR group.Compared with PDR group,the levels of GLU,bloodpressure and duration of disease increases significantly in the NPDR group(P<0.05).Logistic multivariate regressionanalysis showed that FBG,D-D,duration of disease,GLU and blood pressure were independent risk factorsfor retinopathy in type2diabetic patients.Conclusion Coagulation function is abnormal in patients with type2diabetic retinopathy.The coagulation function,duration of disease,GLU,blood lipid and blood pressure should bemonitored regularly to improve the hypercoagulable state of blood in patients with type2diabetic retinopathy.