糖耐量异常患者凝血功能变化及二甲双胍的干预效应  

Blood coagulation function changes and intervention effects of metformin in patients with impaired glucose tolerance

作　　者：王中英[1] 

机构地区：[1]菏泽医学专科学校内科学教研室,山东菏泽274000

出　　处：《中国医师进修杂志》2015年第1期20-22,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨糖耐量异常患者凝血功能变化及二甲双胍的干预效应.方法 将100例糖耐量异常患者按照随机数字表法分为试验1组和试验2组,每组50例,另选择健康志愿者50例作为对照组.试验2组给予二甲双胍治疗,试验1组给予安慰剂治疗.治疗前后各组行口服葡萄糖耐量试验（OGTT）,检测糖负荷后2h血糖（2 h PBG）,并检测糖化血红蛋白以及凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fib）.结果 治疗前试验1组和试验2组2 h PBG、糖化血红蛋白、Fib均明显高于对照组,Am、PT明显低于对照组,差异有统计学意义（P＜0.05）.治疗后试验2组2 h PBG、糖化血红蛋白、Fib明显低于试验1组[（6.6±2.5） mmol/L比（7.9±3.6）mmol/L、（5.2±1.3）％比（5.8±1.4）％、（3.0±1.0） g/L比（3.6±1.2） g/L],APTT、PT明显高于试验1组[（34.3±6.8）s比（31.6±6.5）s、（12.6±0.7）s比（12.3±0.7）s],差异有统计学意义（P＜0.05）,且与对照组比较差异无统计学意义（P＞0.05）.三组TT比较差异均无统计学意义（P＞0.05）.Pearson直线相关分析结果显示,APTT、PT与2hPBG和糖化血红蛋白呈负相关（P＜0.01）,Fib与2h PBG和糖化血红蛋白呈正相关（P＜0.01）,TT与2hPBG和糖化血红蛋白无相关性（P＞0.05）.结论 糖耐量异常患者已出现凝血功能异常,适当的干预治疗可降低心血管疾病的危险因素.Objective To investigate the blood coagulation function changes and intervention effects of metformin in patients with impaired glucose tolerance.Methods One hundred patients with impaired glucose tolerance and 50 healthy volunteers （control group） were recruited.The patients with impaired glucose tolerance were divided into test group 1 and test group 2 by random digits table method.The patients in test group 2 were given metformin and the patients in test group 1 were given the same dosage of placebo.The oral glucose tolerance test （OGTT）,glycosylated hemoglobin （HbA1c）,prothrombin time （PT）,activated partial thromboplastin time （APTT）,thrombin time （TT） and fibrinogen （Fib） level were determined before and after treatment.Results Compared with those in control group,the patients in test group 1 and test group 2 had higher level of 2 h postprandial blood glucose （2 h PBG）,HbA1c and Fib,and lower level of APTT,PT （P 〈 0.05）.The level of 2 h PBG,HbA1c and Fib in test group 2 were significantly lower than those in test group 1,（6.6 ± 2.5） mmol/L vs.（7.9 ± 3.6） mmol/L,（5.2 ± 1.3）% vs.（5.8 ± 1.4）%,（3.0 ± 1.0） g/L vs.（3.6 ± 1.2） g/L,and the level of APTT and PT were significantly higher than those in test group 1,（34.3 ± 6.8） s vs.（31.6 ± 6.5） s,（12.6 ± 0.7） s vs.（12.3 ± 0.7） s,P 〈 0.05.Compared with those in control group,there were no significant differences （P 〉 0.05）.Pearson line correlation analysis revealed that APTT and PT had negative correlation with 2 h PBG and HbA1c （P 〈 0.01）,and Fib had positive correlation with 2 h PBG and HbA1c （P 〈 0.01）.TT had no correlation with 2 h PBG and HbA1c （P 〉 0.05）.Conclusion Blood coagulation function of patients with impaired glucose tolerance may have some alteration,and appropriate therapeutic intervention can reduce the risk factors for cardiovascular disease.

关 键 词：葡糖耐量试验 二甲双胍 凝血功能 

分 类 号：R587.1[医药卫生—内分泌]