2型糖尿病伴冠心病患者平均血小板体积的影响因素研究

目的:研究血糖和血脂等对合并2型糖尿病(DM)冠心病患者平均血小板体积(MPV)的影响。方法:冠状动脉造影等确诊的无糖代谢异常冠心病患者(非DM组)115例,合并DM的冠心病患者(DM组)183例,测定外周血MPV等血小板参数和其他常规实验室指标,分析合并DM冠心病患者MPV的变化及血糖和血脂等对MPV的影响。结果:MPV于DM组显著高于非DM组(10.30±0.88)vs.(10.04±1.03)fL,P<0.05];DM组患者各亚组间比较,肥胖亚组显著高于非肥胖亚组(10.51±0.77)vs.(10.21±0.91)fL,P<0.05],既往DM亚组显著高于新诊断DM亚组(10.41±0.88)vs.(10.14±0.85)fL,P<0.05],HbA1c高值(HbA1c≥7%)亚组显著高于HbA1c低值(HbA1c<7%)亚组(10.47±0.76)vs.(10.16±0.94)fL,P<0.05];MPV分别与体质量指数(BMI)(r=0.149,P=0.044)、空腹血糖(FBG)(r=0.191,P=0.009)、HbA1c(r=0.189,P=0.01)、hs-CRP(r=0.146,P=0.048)和白细胞计数(WBC)(r=0.169,P=0.022)显著正相关,与HDL-C显著负相关(r=-0.143,P=0.053);多元回归分析显示,对MPV有独立影响的因素是HDL-C、HbA1c、hs-CRP和FBG(均P<0.05)。结论:DM冠心病患者MPV进一步升高,MPV的升高与HDL-C、HbA1c、hs-CRP和FBG有密切关系。

Mean platelet volume in coronary artery disease patients with type 2 diabetes mellitus and its relevance of blood glucose and lipids

Objective:To observe the changes of mean platelet volume(MPV) in coronary artery disease(CAD) patients with type 2 diabetes mellitus(DM) and its relevance of blood glucose and lipids.Methods: Total 298 CAD patients diagnosed by coronary angiography were enrolled in the study.They included 115 patients without abnormal glucose metabolism and 183 patients with DM.MPV and other clinical routine laboratory parameters were measured.Results: MPV was significantly higher in patients with DM than in patients without abnormal glucose metabolism(10.30±0.88) vs.(10.04±1.03) fL,P<0.05].Patients with DM were divided into several subgroups.MPV was much higher when obesity subgroup compared to non-obesity subgroup(10.51±0.77) vs.(10.21±0.91) fL,P<0.05],already diagnosed-DM subgroup compared to new diagnosed-DM subgroup(10.41±0.88) vs.(10.14±0.85) fL,P<0.05],high value HbA1c subgroup(HbA1c≥7%) compared to low value HbAc1 subgroup(HbA1c<7%)(10.47±0.76) vs.(10.16±0.94) fL,P<0.05].In CAD patients with DM,MPV was positively correlated with body mass index(BMI)(r=0.149,P=0.044),fasting blood glucose(FBG)(r=0.191,P=0.009),HbA1c(r=0.189,P=0.01),hs-CRP(r=0.146,P=0.048)and white blood cell count(WBC)(r=0.169,P=0.022),negatively related with HDL-C(r=-0.143,P=0.053).Multivariate regression analysis showed that HDL-C,HbA1c,hs-CRP and FBG were the independent predictors of MPV in CAD patients with DM(all P<0.05).Conclusion: The study suggests that MPV is significantly increased in CAD patients with DM.The increased MPV are associated with HDL-C,HbA1c,hs-CRP and FBG.