2型糖尿病并急性缺血性脑卒中患者凝血功能紊乱的临床分析

Clinical analysis on coagulopathy in type 2 diabetic patients with acute cerebral infarction

目的:探讨2型糖尿病伴急性缺血性脑卒中患者凝血功能的变化。方法:选取2型糖尿病伴急性缺血性脑卒中患者90例作为观察组,选择2型糖尿病患者90例作为2型糖尿病组,同期选择健康成人80例作为对照组,观察患者的脑梗死面积及各组部分凝血酶原时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)和D-D二聚体(D-D)等指标。根据脑梗死面积,将观察组分为腔隙性脑梗死组、小梗死组及大梗死组,观察3组患者的部分凝血酶原时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)和D-D二聚体(D-D)等指标。结果:与对照组比较,T2DM组及观察组患者APTT及PT降低,FIB及D-D水平增高,差异均有统计学意义(P<0.05);观察组APTT及PT低于T2DM组,FIB及D-D水平则高于T2DM组,差异均有统计学意义(P<0.05)。与腔隙性脑梗死组比较,小梗死组与大梗死组APTT、PT降低,且大梗死组低于小梗死组,差异有统计学意义(P<0.05);与腔隙性脑梗死组比较,小梗死组与大梗死组FIB及D-D水平升高,且大梗死组高于小梗死组,差异均具有统计学意义(P<0.05)。结论:2型糖尿病伴急性缺血性脑卒中患者存在凝血功能异常并与疾病严重程度相关,可作为急性脑梗死患者病情严重程度的评估指标。

Objective: To explore the coagulation function in type 2 diabetes mellitus(T2 DM)patients with acute cerebral infarction(ACI). Methods: 90 T2 DM patients with ACI were selected as the observation group. 90 T2 DM patients without ACI were selected as T2 DM group. 80 healthy people were selected as control group. The brain infarction area and the level of APTT, PT, FIB and D-D of each group were compared. According to the infarction area, the observation group was divided into lacunar infarction group, small area infarction group and large area infarction group. The level of APTT, PT, FIB and D-D of three groups were observed. Results: Compared with control group, the level of APTT and PT were decreased significantly and the level of FIB and D-D were increased significantly in T2 DM group and the observation group(P< 0.05). There was significantly difference of the level of APTT, PT, FIB and D-D between T2 DM group and the observation group(P<0.05). Compared with lacunar infarction group, the level of APTT and PT were decreased significantly and the level of FIB and D-D were increased significantly in small area brain infarction group and large area brain infarction group(P<0.05). There was significantly difference of the level of APTT, PT, FIB and D-D between small area brain infarction group and large area brain infarction group(P<0.05). Conclusion: The coagulation function is found in T2 DM patients with ACI and related to the severity of the disease. It could be served as the severity indicator of acute cerebral infarction.