2型糖尿病与凝血功能障碍

目的　探讨2型糖尿病(2DM)患者凝血功能指标的变化,及其与血管并发症的关系。方法　分别检测糖尿病组(n=85 )和对照组(n =6 0 )血浆凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、甘油三酯(TG)、胆固醇(CH)。结果　(1) 2DM组与对照组比较:无论有无血管并发症2DM患者PT、APTT显著下降(P <0 .0 5或P <0 0 1) ,FIB显著上升(P <0 .0 5或P <0 .0 1) ,无血管病变组TT的变化没有统计意义;伴血管病变组患者TT显著下降(P <0 0 1)。(2 ) 2DM组组内比较,伴血管病变组凝血指标PT、APTT、TT均较无血管病变组显著下降(P <0 0 1) ,且FIB水平显著上升(P <0 .0 5 )。(3)DM患者血脂异常的分型比较,DM患者以高甘油三酯血症为主,有血管并发症组的高甘油三酯血症阳性率可达2 8.9% ,但两组差异不明显(P >0 .0 5 ) ;并且TG与四项凝血指标均无明显相关性。结论　2型糖尿病患者存在凝血功能的障碍,且随着血管并发症的出现,患者凝血活性增强。

Coagulation Disturbance in Patients with Type 2 Diabetes Mellitus

s:Objective To investigate changes of plasma coagulation parameters in type 2 diabetes mellitus,and the relationship of plasma coagulation parameters with angiopathy.Methods The levels of prothrombin time(PT),partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),triglyceride(TG),total cholesterol(CH) were determined in patients with type 2 diabetes mellitus(n=85) and controls(n=60).Results Compared with those of control group,the levels of PT,APTT were significantly shorter in diabetes mellitus,the level of fibrinogen(FIB) increased.Furthermore,in diabetes patients,those with micro or macroangiopathy showed shorter the levels of APTT,TT and higher the level of FIB.These changes of plasma coagulation parameters have independent relationship with serum TG.Conclusions Patients with type 2 diabetes mellitus could cause coagulation disturbance,there were increasement of blood clotting activity in the paitents with micro or macroangiopathy.