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目的 探讨2型糖尿病(type 2 diabetes,T2DM)伴急性脑梗死(acute cerebral infarction,ACI)患者的凝血功能、血清视黄醇结合蛋白4(retinol binding protein 4,RBP4)、溶血磷脂酸(lysophosphatidic acid,LPA)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)的变化及其意义.方法采用病例对照研究方法,选取2016年6月-2017年6月)珠海市中西医结合医院收治的90例T2DM伴ACI患者(A组)、单纯T2DM患者90例(B组)、健康体检对象90例(C组),采用对三组研究对象的血栓弹力图检测三组的凝血功能、检测三组的指标、血清RBP4、LPA、hs-CRP水平进行回顾性分析,并分析上述指标与A组患者神经功能缺损评分(NIHSS)的关系.结果 B组和C组的R值、K值均显著的高于A组(P<0.05);B组和C组的Angle角、MA值均显著的低于A组(P<0.05);B组和C组的反应时间(reaction time,R)R值、凝固时间(solidification time,K)K值、角度(Angle)Angle角、图中两侧曲线的最宽距离(the maximum distance between two sides of a graph,MA)MA值差异无统计学意义(P＞0.05);B组和C组的血清RBP4、LPA、hs-CRP水平均显著的低于A组(P<0.05),C组的血清RBP4、LPA、hs-CRP水平均显著的低于B组(P<0.05);A组的R值、K值与患者NIHSS评分呈显著的负相关关系(P<0.05),A组的Angle角、MA值与患者NIHSS评分呈显著的正相关关系(P<0.05);A组的血清RBP4、hs-CRP水平与患者NIHSS评分呈显著的正相关关系(P<0.05),A组的LPA与患者NIHSS评分无相关关系(P<0.05).结论 T2DM伴ACI患者凝血功能、血清RBP4、LPA、hs-CRP水平较单纯T2DM患者及健康人群发生显著改变,并且与患者神经功能缺损程度关系具有一定的相关性.“,”Objective To investigate the changes of coagulation function, serum RBP4, LPA and hs-CRP in patients with T2DM and ACI. Methods A case-control study was conducted to select 90 patients with T2DM and ACI (group A) admitted to author’s hospital,90 patients with T2DM alone (group B),90 healthy subjects (group C), The thromboelastography index, serum RBP4, LPA, and hs-CRP levels of the three groups were retrospectively analyzed. The relationship between the above indicators and the neurological deficit score (NIHSS) in group A patients was analyzed.Results The R and K values of group B and group C were significantly higher than those of group A (P<0.05). The angles of Angle and MA of group B and group C were significantly lower than those of group A (P<0.05). There were no significant differences in R value, K value, Angle angle and MA value between group B and group C (P＞0.05). Serum RBP4, LPA, and hs-CRP levels in group B and group C were significantly lower than those in group A (P<0.05). Serum RBP4, LPA, and hs-CRP levels in group C were significantly lower than those in group B (P<0.05). There was a significant negative correlation between the R value and K value of group A and the NIHSS score of patients (P<0.05). There was a significant positive correlation between Angle angle and MA value of group A and NIHSS score of patients (P<0.05). Serum RBP4 and hs-CRP levels in group A were significantly positively correlated with NIHSS scores (P<0.05). There was no correlation between LPA in group A and NIHSS score in patients (P<0.05). Conclusion The levels of blood coagulation, serum RBP4, LPA, and hs-CRP in patients with T2DM and ACI were significantly different from those in patients with simple T2DM and healthy people, and had a certain correlation with the degree of neurological deficit.