老年2型糖尿病与血小板、凝血及纤溶功能的相关性

Correlation of Platelet Function,Coagulation and Fibrinolytic System Function in Elderly Patients with Type 2 Diabetes

目的探讨老年2型糖尿病患者的血小板功能、凝血功能、纤溶系统的特点。方法选取193例患者,按WHO标准诊断标准分为2型糖尿病组(DM组,97例)和对照组(NC组,96例)。收集所有患者的性别、年龄、糖尿病病程、吸烟史、SBP、DBP、BMI、FPG、2 hPG、HbA1c、FC、TC、TG、ACT、PF、D-2聚体等指标,比较以上指标的组间差异。并对PF、D-2聚体相关因素行Pearson相关性分析及多元线性回归分析。结果(1)糖尿病组BMI、D-2聚体、ACT较对照组高,组间差异有统计学意义(P<0.05);(2)Pearson相关性分析:D-2聚体值与年龄、BMI、糖尿病病程具有显著正相关性(P<0.05),与糖化血红蛋白百分比正相关性更为显著(P<0.01);PF与餐后2 h胰岛素、餐后2 h C肽具有显著负相关性(P<0.05),与空腹血糖正相关性更为显著(P<0.01);(3)多重线性回归分析:年龄和糖化血红蛋白百分比与D-2聚体存在正相关关系(P<0.05);空腹血糖与PF存在正相关关系,餐后2 h胰岛素与PF存在负相关关系(P<0.05)。结论老年2型糖尿患者存在血小板功能、凝血功能、纤容系统功能异常,高血糖、胰岛功能差可能是其主要原因。

Objective To investigate the platelet function,coagulation function and fibrinolytic system in elderly patients with type 2 diabetes.Methods 193 patients were divided into type 2 diabetes group(group DM,97 cases)and control group(group NC,96 cases)according to WHO standard diagnostic criteria.The gender,age,duration of diabetes,smoking history,SBP,DBP,BMI,FPG,2 h PG,HbA1c,FC,TC,TG,ACT,PF,and aggregation polymer were collected and compared among the patients.Pearson correlation analysis and multiple linear regression analysis were performed on the related factors of PF and D-2 polymer.Results(1)The levels of BMI,D-2 polymer and ACT in the DM group were higher than those in the control group(P<0.05).(2)Pearson correlation analysis:The value of D-2 aggregate was positively correlated with age,BMI,and duration of diabetes(P<0.05),and positively correlated with the percentage of glycosylated hemoglobin(P<0.01).PF had significant negative correlation with the levels of 2 h postprandial insulin and C peptide(P<0.05),and more significant positive correlation with fasting blood glucose(P<0.01).(3)Multiple linear regression analysis:age and percentage of glycosylated hemoglobin were positively correlated with D-2 polymer(P<0.05).There was a positive correlation between fasting blood glucose and PF,and a negative correlation between insulin and PF at 2 hours after meal(P<0.05).Conclusion There are abnormal platelet function,coagulation function and fibrous function system in elderly patients with type 2 diabetes mellitus,high state of blood glucose and poor function of isolated islets may be the main reasons.