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目的:观察糖尿病患者血循环中细胞组织因子促凝血活性(TF-PCA)和血浆中同型半胱氨酸(Hcy)变化,探讨糖尿病血管并发症的发病机制。方法:TF-PCA采用内毒素刺激全血凝固法(TiFaCT法),Hcy采用生化法。结果:测得糖尿病无血管并发症患者TF-PCA为50.3±29.6TF-PCA△s,血浆Hcy浓度为(11.89±6.39)μmol/L,伴有血管病变患者TF-PCA为82.3±33.8TF-PCA△s,血浆Hcy浓度为(25.10±7.84)μmol/L,均较正常对照组显著增高,而且伴血管病变患者的增高更为明显,TF-PCA和Hcy的改变有显著的相关性。结论:糖尿病患者全血TF-PCA增强提示存在血栓前状态,血浆Hcy浓度的增高提示糖尿病患者有不同程度的血管损伤,对TF-PCA和Hcy的监测有利于糖尿病并发症血管病变的防治。
Objective: To observe the changes of cytokines procoagulant activity (TF-PCA) and plasma homocysteine (Hcy) in the blood circulation of diabetic patients and explore the pathogenesis of diabetic vascular complications. Methods: TF-PCA was stimulated by endotoxin in whole blood coagulation method (TiFaCT method), Hcy biochemical method. Results: TF-PCA was 50.3 ± 29.6TF-PCA △ s in patients with diabetes without vascular complications, the plasma Hcy concentration was (11.89 ± 6.39) μmol / L and the TF-PCA in patients with vascular lesions was 82.3 ± 33.8TF- PCA △ s, plasma Hcy concentration (25.10 ± 7.84) μmol / L, were significantly higher than the normal control group, and patients with vascular lesions increased more significantly, TF-PCA and Hcy changes were significantly correlated. Conclusion: The increase of TF-PCA in whole blood of diabetic patients suggests the existence of prethrombotic state. The increase of plasma Hcy level suggests that the diabetic patients have different degrees of vascular injury. The monitoring of TF-PCA and Hcy is beneficial to the prevention and treatment of diabetic complications.