血管性血友病因子在老年2型糖尿病中的变化及其与冠心病关系的研究

目的研究老年2型糖尿病患者血管性血友病因子(vWF)水平的变化及其与冠心病的关系。方法选择老年2型糖尿病患者115例,非糖尿病患者122例。抽取空腹血测定血浆vWF水平及空腹血糖、糖化血红蛋白(HbA1c)、总胆固醇、低密度脂蛋白、高密度脂蛋白、三酰甘油、尿酸、纤维蛋白原、D-二聚体等生化及凝血指标,清晨留尿测定尿白蛋白/肌酐比值。按照有无糖尿病及糖尿病组中按有无冠心病分组比较各指标变化,分析相关性。结果老年2型糖尿病患者较非糖尿病者血浆vWF水平明显升高〔(189.8±56.2)%和(140.3±35.6)%,t=3.579,P=0.000〕。在老年2型糖尿病者中,冠状动脉造影证实或有明确心肌梗死病史的冠心病者较非冠心病者vWF水平明显升高〔(197.3±52.5)%和(172.8±54.5)%,t=1.925,P=0.032〕。vWF与各项临床指标无相关性。结论老年2型糖尿病患者反映内皮功能异常的vWF已有增高,且与2型糖尿病冠心病的发生存在一定关联。

Changes of von Willebrand Factor in Senile Patients with Type 2 Diabetes Mellitus and Its Relationship with Coronary Artery Disease

Objective To investigate the changes of von Willebrand factor(vWF) in senile patients with type 2 diabetes mellitus(T2DM) and its relationship with coronary artery disease(CAD).Methods Totally 115 senile T2DM patients(T2DM group) and 122 senile patients without diabetes(control group) were included in this study.The level of serum vWF,fasting glucose,HbA1c,cholesterol,low-density lipoprotein,high-density lipoprotein,triglycerides,uric acid,fibrinogen,and D-dimer were measured.Creatinine ratio of urinary albumin was measured in a first-morning-void urine sample.Clinical data and some biochemical items were compared between the T2DM group and control group and between those with or without CAD.The correlation of these items was analyzed simultaneously.Results Compared with the control group,the T2DM group had significantly higher vWF level((189.8±56.2)% vs(140.3±35.6)%,P<0.01).Inside the T2DM group,vWF in patients with coronary artery disease(CAD) was significantly higher than in those without CAD((197.3±52.5)% vs(172.8±54.5)%,P<0.05).No correlation was observed between vWF and other clinical items.Conclusion Senile T2DM patients tend to have higher vWF levels,which shows certain association with CAD.