糖化血红蛋白与血小板参数及纤维蛋白原的关系探讨  

Relationship among HbAlc,blood platelet parameters and fibrinogen

作　　者：李秀文[1] 方晓璐[1] 张毅华[1] 

机构地区：[1]辽宁省大连市中心医院检验科,116033

出　　处：《检验医学与临床》2008年第1期1-2,共2页Laboratory Medicine and Clinic

摘　　要：目的探讨糖尿病的控制程度指标:糖化血红蛋白(HbAlc)与微循环敏感指标血小板参数和纤维蛋白原(Fbg)的关系。方法对研究对象的HbAlc、血小板参数即血小板数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)及纤维蛋白原(Fbg)等指标进行测定,并根据HbAlc的高低及有无微血管病变将糖尿病患者分为三组:HbAlc升高A组(HbAlc>6.0%)即血糖控制不佳且伴有微血管病变的糖尿病患者;HbAlc升高B组(HbAlc>6.0%)即血糖控制不佳但无微血管病变的糖尿病患者;HbAlc正常C组(HbAlc≤6.0%)即血糖维持相对稳定且无微血管病变的糖尿病患者。并将三组的血小板参数及Fbg结果与健康对照(非糖尿病)组进行统计学比较。结果A、B组的多项指标与健康对照组的差异有统计学意义(P<0.01),而C组与健康对照组差异无统计学意义(P>0.05)。结论微循环敏感指标MPV、PDW及Fbg与HbAlc具有相关性。对HbAlc升高的糖尿病患者,无论有无临床指征,其微循环敏感指标已发生改变,应定期监测血小板参数(血常规)和Fbg,以便及时纠正糖尿病血管及微血管病变的并发症。Objective To investigate the relationship among HbAlc, blood platelet parameters and fibrinogen connection. Methods 155 patients with DDM and 80 healthy people were enrolled in the study. HbAlc, blood platelet parameters including platelet count, mean platelet volume （MPV） and platelet distribution width （PDW）, and fibrinogen （Fbg） were determined for all subjects. According to the HbAlc level and microvascular changes, 155 DDM patients were divided into three groups： group A （HbAlc〉6.0%, complicated with microvascular changes）, group B （HbAlc〉 6.0 %, without microvascular changes） and group C （HbAlc≤6.0 %, keeping a relatively steady blood glucose level, without microvascular changes）. The results of platelet parameters and Fbg were compared and statistically analyzed between three disease groups and healthy control group. Results The differences of multiple parameters were statistically significant between group A, B and healthy control group （P（0.01）. On the contrary, there was no significant differences of multiple parameters between group C and healthy control group （P〉0.05）. Conclusion The microvascular sensitive parameters （MPV, PDW and Fbg） are correlated with HbAlc. For DDM patients with a elevated HbAlc level, their microvascular sensitive parameters have changed, whether there are clinical signs or not. It suggests that platelet parameters and Fbg should be monitored periodically, so as to rectify vascular or microvascular changes complicated with DDM.

关 键 词：糖化血红蛋白 血小板参数 纤维蛋白原 糖尿病血管并发症 

分 类 号：R446.113[医药卫生—诊断学]