2型糖尿病患者凝血功能水平与血管病变发生的相关性  

Relationship between Coagulation Function and Vascular Disease in Patients with Type 2 Diabetes Mellitus

作　　者：贾文丽[1] 张林[1] 程淑杰[1] 李冬梅 张昕[3] 

机构地区：[1]内蒙古巴彦淖尔市医院内分泌科,内蒙古巴彦淖尔015000 [2]内蒙古自治区人民医院内分泌科,内蒙古呼和浩特010059 [3]内蒙古巴彦淖尔市医院感染科,内蒙古巴彦淖尔015000

出　　处：《现代生物医学进展》2016年第24期4767-4769,4782,共4页Progress in Modern Biomedicine

基　　金：内蒙古自治区自然科学基金项目(2010114)

摘　　要：目的:探讨2型糖尿病患者凝血功能及血清肿瘤坏死因子α(TNF-α)及白细胞介素18(IL-18)水平与糖尿病血管病变的关系。方法:选择2014年6月-2015年10月在我院接受治疗的2型糖尿病患者83例作为研究对象,根据患者疾病进展情况将其分为血管病变组(45例)和无血管病变组(38例)。测定两组患者凝血酶时间(TT)、活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(Fg)、血糖(Glu)、糖化血红蛋白(Hb A1c)、肿瘤坏死因子α(TNF-α)及白细胞介素18(IL-18)水平;采用logistics回归分析2型糖尿病患者发生血管病变的危险因素。结果:血管病变组患者Glu,Hb A1c及Fg水平均显著高于无血管病变组,而APTT及PT水平均显著低于无血管病变组,差异均具有统计学意义(P<0.05);两组间TT水平比较,差异无统计学意义(P>0.05)。血管病变组患者血清中TNF-α及IL-18水平均高于无血管病变组患者,差异具有统计学意义(P<0.05)。Hb A1c,Fg,TNF-α以及IL-18水平异常是2型糖尿病患者发生血管病变的独立危险因素(OR=1.23,1.45,2.632,3.884,P<0.05)。结论:凝血功能紊乱及炎症反应是2型糖尿病患者发生血管病变的重要因素,临床应给予重视。Objective： To explore the relationship between coagulation function and serum TNF-α and IL-18 levels and vascular lesions of patients with type 2 diabetes. Methods： 83 patients with type 2 diabetes who were treated in our hospital from June 2014 to October 2015 were selected as the research objects, and according to the progress of the disease, the patients were divided into the vascular lesion group （45 cases） and the non vascular lesion group （38 cases）. Then the thrombin time （TT）, activated partial thromboplastintime （APTT）,prothrombintime （PT）,fibrinogen （FG）,glucose （Glu）,glycosylatedhemoglobin （HbAlc） andserum TNF-α and IL-18 levels were detected, and the risk factors of vascular disease in type 2 diabetes was analyzed by logistic regression analysis. Results： The levels of Glu, HbAlc and Fg in the vascular lesion group were significantly higher than those of the non vascular lesion group, and the levels of APTT and PT were significantly lower, and the differences were statistically significant （P〈0.05）. There was no significant difference in the level of TT between the two groups （P〉0.05）. The levels of IL-18 and TNF-α in the serum of vascular lesion group were higher than those of the non vascular lesion group, and the differences were statistically significant （P〈0.05）. Independent risk factors for vascular disease were the levels changes of HbA1c, Fg, TNF-α and IL-18 （P〈0.05）. Conclusion： Coagulation disorders and inflammatory response is an important factor in the occurrence of vascular disease in patients with type 2 diabetes, which should pay more attention.

关 键 词：2型糖尿病 血管病变 凝血功能 TNF-Α IL-18 

分 类 号：R587.2[医药卫生—内分泌]