糖尿病性眼肌麻痹患者血液流变学分析

目的探讨2型糖尿病性眼肌麻痹患者血液流变学改变。方法本研究共纳入168例对象,分为3组:正常对照(NC)组56例、单纯糖尿病(T2DM)组56例和糖尿病性眼肌麻痹(T2DM+OMP)组56例。进行隔夜空腹12 h血HbA1c、空腹血糖(FBG)、餐后2 h血糖(2hPG)、血液流变学检测,并对其进行相关性分析。结果 T2DM+OMP组除红细胞变形指数显著低于T2DM组及NC组外(P均<0.01),HbA1c、FBG、2hPG及其他血液流变学指标均显著高于T2DM组及NC组(P均<0.01)。T2DM+OMP组除红细胞变形指数与FBG、HbA1c呈负相关外(P均<0.01),全血黏度(低切、中切、高切)、血浆黏度、纤维蛋白原与血糖、HbA1c呈正相关(P均<0.05)。结论糖尿病眼肌麻痹患者血液流变学异常,血液黏稠度增高、红细胞变形能力减退而聚集性增高、纤维蛋白原增高、血小板凝聚功能增加等,导致微血栓形成和/或微血管闭塞,引起组织细胞缺血、缺氧,导致急性或亚急性血管源性神经病变。

Analysis of hemorheology in patients with diabetic ophthalmoplegia

Objective It is to analyze the change of hemorheology of patients with type 2 diabetic ophthalmoplegia(OMP).Methods 168 people were recruited into this study,and they were divided into three groups: normal control(NC) group(n=56),simple type 2 diabetic mellitus(T2DM) group(n=56) and T2DM with OMP group(n=56).Venous blood samples were collected from all the subjects in the three groups to determine HbA1c,fasting blood glucose(FBG),postprandial blood glucose(2hPG) and hemorheological indices after fasting for 12h.The correlation analysis was performed among these indexes.Results Except for RBC deformation index which was significantly lower in T2DM+OMP group than that in the other two groups(P<0.01),the levels of plasma FBG,2hPG,HbA1c and most of the hemorheological indices were significantly higher that those in the other two groups(P<0.01).In T2DM+OMP group,FBG and HbA1c were positively correlated with whole blood viscosity(high shear,midder shear,low shear),plasma viscosity and fibrinogen,and were negatively correlated with plasma RBC deformation index(all P<0.01).Conclusion Blood rheology was abnormal in patients with type 2 diabetic ophthalmoplegia with increased blood viscosity,lower erythrocyte deformation ability and high aggregation,high level of fibrinogen,strengthened platelet coagulation function which lead to microthrombosis and/or domain microvascular block,tissue cell ischemia,anaerobic,and finally lead to acute or subacute vasogenic neuropathy.