血栓弹力图检测老年动脉粥样硬化合并2型糖尿病患者凝血功能的变化

Application of Thromboelastography to Detect Coagulation Function in Elderly Patients with Atherosclerosis Complicated with Type 2 Diabetes

目的探讨血栓弹力图(thrombelastography,TEG)检测老年动脉粥样硬化合并2型糖尿病患者凝血功能的变化。方法选取动脉粥样硬化患者160例,年龄大于65岁,分为糖尿病组100例,其中男54例,女46例;非糖尿病组60例,其中男37例,女23例;糖尿病组中根据糖化血红蛋白情况分为两个亚组,即血糖控制组(糖化血红蛋白<6. 50%) 55例,其中男28例,女27例,血糖未控制组(糖化血红蛋白≥6. 50%) 45例,其中男26例,女19例,进行TEG检测。结果 (1)与非糖尿病组比较,糖尿病组患者R值时间[(7. 05±1. 30) vs(5. 67±1. 19) min]缩短(P <0. 05); K值[(2. 47±0. 44) vs(2. 09±0. 57) min]缩短(P <0. 05); Angle角[(58. 73±6. 92) vs(62. 88±7. 34) deg]增大(P <0. 05)、MA值[(58. 33±6. 40) vs(62. 83±6. 05) mm]升高(P <0. 05)。(2)糖尿病组内亚组中,与血糖控制组比较,血糖未控制组R值时间[(5. 96±1. 10) vs(5. 31±1. 22) min]减低(P <0. 05); K值[(2. 28±0. 47) vs(1. 86±0. 59) min]缩短(P <0. 05); MA值[(61. 19±4. 59) vs(64. 83±7. 00) mm]升高(P <0. 05)。结论老年动脉粥样硬化合并2型糖尿病患者的凝血功能处于高凝状态,而积极有效的控制血糖能减低高凝状态水平。TEG指标能反映该类患者的凝血功能变化。

Objective To investigate the changes of coagulation function in elderly patients with atherosclerosis complicated with type2diabe tes by thromboelastography(TEG).Methods A total of160patients over65years old with atherosc lerosis were enrolled and divided into diabetic group(n=100,54males,46female s)and no diabetes group(n=100,37males,23females).According to the levels of glycosylated hemoglobin,the diabetic group was divided into two subgroups,name ly,55patients in blood glucose controlled group(glycosylated hemoglobin<6.50),including28males and27females;and45patients in uncontrolled blood gl ucose group(glyosylated hemoglobin≥6.50),including26males and19females.All subjects were tested by TEG.Results(1)Compared with the non-diabetic group,the reaction t ime[(7.05±1.30)vs(5.67±1.19)min]was shortened(P<0.05);K valu e[(2.47±0.44)vs(2.09±0.57)min]was shortened(P<0.05);Angle[(58.73±6.92)vs(62.88±7.34)deg]increased(P<0.05),MA numerical value[(58.33±6.40)vs(62.83±6.05)mm]increased(P<0.05).(2)In t he subgroup of the diabetic group,compared with the blood glucose controlled gr oup,the reaction time of the uncontrolled blood glucose group[(5.96±1.10)vs(5.31±1.22)min]decreased(P<0.05);Kvalue[(2.28±0.47)vs(1.86±0.59)min]shortened(P<0.05);MA value[(61.19±4.59)vs(64.83±7.00)mm]increased(P<0.05).Conclusions Hypercoagulability could occur in elderly patients w ith atherosclerosi s complicated with type2diabetes,and it can be reduced by the effective contr ol of blood glucose.The TEG indicator can reflect changes in coagulation funct ion in this type of patients.