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目的探讨糖尿病微血管病变患者体内血栓前体蛋白(TpP)浓度和抗凝血酶Ⅲ(AT-Ⅲ)活性改变及其与糖尿病合并脑梗死的关系。方法选取糖尿病微血管病变患者101例和正常对照(NC)者31名,观察各组TpP浓度、AT-Ⅲ活性变化及脑梗死发生的风险指标。结果与NC组相比,糖尿病微血管病变组TpP浓度高[(5.53±3.16)vs(3.86±1.37)μg/ml,P<0.05]、AT-Ⅲ活性低[(92.26±13.97)%vs(102.24±10.45)%,P<0.05]。糖尿病微血管病变合并脑梗死亚组、糖尿病微血管病变未合并脑梗死亚组和NC组TpP浓度、AT-Ⅲ活性比较差异有统计学意义[(6.82±4.12)vs(4.88±2.32)vs(3.86±1.37)μg/ml,P<0.05;(86.21±13.47)%vs(95.33±13.30)%vs(102.24±10.45)%,P<0.05]。Logistic多元回归分析显示,年龄、SBP、TpP、AT-Ⅲ与脑梗死发生独立相关。结论糖尿病微血管病变组TpP浓度升高,AT-Ⅲ活性降低,糖尿病患者机体处于血栓前状态,存在血栓形成风险。糖尿病患者联合检测血浆TpP浓度和AT-Ⅲ活性,有助于血栓性疾病的早期发现及治疗。
Objective To investigate the changes of thrombus precursor protein (TpP) and antithrombin Ⅲ (AT-Ⅲ) activity in patients with diabetic microangiopathy and its relationship with cerebral infarction complicated by diabetes mellitus. Methods Totally 101 patients with diabetic microangiopathy and 31 normal controls were enrolled in this study. TpP concentration, AT-Ⅲ activity and the risk of cerebral infarction in each group were observed. Results Compared with NC group, the TpP concentration in diabetic microangiopathy group was significantly higher than that in NC group [(5.53 ± 3.16) vs (3.86 ± 1.37) μg / ml, P <0.05] ± 10.45)%, P <0.05]. There were significant differences in TpP concentration and AT-Ⅲ activity between diabetic microangiopathy and cerebral infarction subgroups and diabetic microangiopathy subgroups and NC group [(6.82 ± 4.12 vs 4.88 ± 2.32 vs 3.86 ± 1.37) μg / ml, P <0.05; (86.21 ± 13.47)% vs (95.33 ± 13.30)% vs (102.24 ± 10.45)%, P <0.05]. Logistic multiple regression analysis showed that age, SBP, TpP and AT-Ⅲ were independently associated with cerebral infarction. Conclusions Diabetic microangiopathy group TpP concentration increased, AT-Ⅲ activity decreased, the body of patients with diabetes in a prothrombotic state, there is the risk of thrombosis. Diabetes patients combined detection of plasma TpP concentration and AT-Ⅲ activity, contribute to the early detection and treatment of thrombotic diseases.