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目的 观察 2型糖尿病患者凝血指标的变化及其临床意义。方法 利用双抗体夹心ELISA法检测 6 5例 2型糖尿病患者 (其中 33例合并血管病变 )及 38名健康对照者血浆血管性假性血友病因子抗原 (vWF :Ag)、凝血酶调节蛋白 (TM)、凝血酶原片段 (F1+ 2 )、血小板选择素 (P selectin)水平。结果 糖尿病组血浆vWF :Ag (14 7.3± 2 9.5 ) %、TM (2 9.9± 11.3) μg/L、F1+ 2 (0 .78± 0 .19)nmol/L、P selectin (16 .9± 3.2 ) μg/L水平均显著高于健康对照组 ,差异有显著意义 (P <0 .0 5～ 0 .0 1) ;有血管病变的患者血浆vWF :Ag (16 1.6± 34.2 ) %、TM (32 .9± 13.2 ) μg/L、F1+ 2 (0 .96± 0 .2 5 )nmol/L、P selectin(19.2± 3.4 ) μg/L水平均显著高于无血管病变组 ,差异有显著意义 (P <0 .0 5～ 0 .0 1) ;相关分析显示 ,F1+ 2 、P selectin与vWF :Ag显著正相关 (r分别为 0 .4 2 3、0 .397,P均 <0 .0 1) ,F1+ 2 、P selectin与TM亦显著正相关 (r分别为 0 .4 5 8、0 .4 11,P均 <0 .0 1)。结论 2型糖尿病患者均存在血管内皮损伤 ,并由此引起血小板活化和血液的高凝状态 ;血浆vWF :Ag、TM、F1+ 2 、P selectin水平在一定程度上可反映 2型糖尿病患者血管病变的情况。
Objective To observe the changes and clinical significance of coagulation index in type 2 diabetic patients. Methods Sixty-five patients with type 2 diabetes mellitus (33 with vascular disease) and 38 healthy controls were enrolled in this study. Plasma vWF (Ag), thrombomodulin TM), prothrombin fragments (F1 + 2), P selectin levels. Results The plasma levels of vWF: Ag (14 7.3 ± 2 9.5)%, TM (29.9 ± 11.3) μg / L and F1 + 2 (0.78 ± 0.19) nmol / L and P selectin (16.9 ± 3.2 ) μg / L were significantly higher than those in the healthy controls (P <0.05-0.01). Plasma vWF: Ag (16.6 ± 34.2)% and TM 32.9 ± 13.2) μg / L, F1 +2 (0.96 ± 0.25) nmol / L, P selectin (19.2 ± 3.4) μg / L were significantly higher than those of non-vascular group, the difference was significant (P <0.05-0.01). Correlation analysis showed that there was a significant positive correlation between F1 + 2 and P selectin and vWF: Ag (r = 0.42 3,0.397, P <0. 0 1), F1 + 2, P selectin and TM were also significantly correlated (r = 0.458,0.41, P <0.01 respectively). Conclusion Both vascular endothelial cell damage and platelet activation and blood hypercoagulability were found in patients with type 2 diabetes. The levels of plasma vWF: Ag, TM, F1 + 2 and P selectin may reflect the changes of vascular lesions Happening.