2型糖尿病患者血栓弹力图与糖化血红蛋白、C-肽和胰岛素的相关性研究  

Association between thrombelastography and glycosylated hemoglobin,fasting c-peptide and insulin in patients with type 2 diabetes mellitus

作　　者：姚敏[1] 吴秀继[1] 何启军[1] 余杏[1] 郑地明[2] 

机构地区：[1]海口市人民医院检验科,570208 [2]海口市人民医院内分泌科,570208

出　　处：《中国糖尿病杂志》2016年第8期705-707,共3页Chinese Journal of Diabetes

基　　金：海口市重点科技计划项目(2013-54)

摘　　要：目的探讨T2DM患者血栓弹力图(TEG)与FPG、HbA_1c、C-P及FIns的相关性。方法选取本院内分泌科门诊T2DM患者102例,其中T2DM病程≤5年53例,T2DM病程>5年49例;另选择健康体检者98名作为对照组(NC)。检测各组TEG及糖代谢指标并进行相关性分析。结果与NC组比较,T2DM组FPG、HbA_1c水平均升高(F=36.81、44.78,P<0.01);T2DM病程>5年组C-P、FIns较NC组升高(F=3.344、5.467,P<0.05)。TEG检测显示,T2DM病程>5年组R值和K值均低于T2DM病程≤5年组和NC组(F=16.07、12.55,P<0.01),MA值、α角及CI值均增大(F=14.14、11.859、9.857,P<0.01);T2DM病程≤5年组和T2DM病程>5年组K值、MA值及α角比较,差异有统计学意义(F=5.154、4.087、3.94,P<0.05)。Pearson相关分析结果显示,T2DM病程>5年组FPG与R值呈负相关(r=-0.258,P=0.047),与CI值呈正相关(r=0.281,P=0.034);HbA_1c与K值呈负相关(r=-0.309,P=0.024),与CI值呈正相关(r=0.297,P=0.026),FIns与CI值呈正相关(r=0.279,P=0.031)。结论 T2DM病程>5年患者TEG多项参数与HbA_1c和FIns水平存在相关性,TEG是监测T2DM患者凝血功能变化的一种有效手段。Objective To explore the correlation of thrombelastography （TEG） and glycosylated hemoglobin （HbA1 c）, fasting c-peptide （C-P）and insulin （Fins）in patients with type 2 diabetes mellitus （T2DM）. Methods 102 out-patients with T2DM were selected from Dec 2012 to May 2014 in Haikou Municipal People＇s Hospital,including 53 cases with duration of 5 years or less and 49 cases with duration more than 5 years. 98 healthy volunteers served as normal controls （NC group）. TEG parameters （R value, K value, MA value, alpha angle and CI value）, HbA1 c, C-P, and Fins were examined and compared among different groups. Results Compared with NC group,the levels of fasting plasma glucose （FPG） and HbA1 c in T2DM group were significantly higher（P〈0. 01） ;C-P and Fins in subgroup DM〉5 years were significantly higher （P〈0.05）. R and K values in subgroup DM〉5 years were significantly lower than those in subgroup DM not more than 5 years and NC group （P〈0.05） ;MA value, CI value and alpha angle were significantly increased （P〈0.05）. K value, MA value and alpha angle had significant differences between two DM subgroups （P〈0.05）. Pearson correlation analysis showed that FPG was negatively correlated with R value （P = 0. 047） and positively correlated with CI value （P = 0. 034） in subgroup DM〉5 years; HbAlc was negatively correlated with K value （P= 0. 024） and positively correlated with CI value （P=0. 026）. Conclusion In patients with T2DM〉 5 years,TEG may be an effective indicator of monitoring the changes of blood coagulation function in T2DM patients.

关 键 词：糖尿病 2型 血栓弹力图 糖化血红蛋白 C-肽 空腹胰岛素 

分 类 号：R587.1[医药卫生—内分泌] R446.1[医药卫生—内科学]