[1]田晓琴,宋琳琳,秦迎雪.2型糖尿病患者并发微血管病变的危险因素分析[J].新乡医学院学报,2023,40(3):262-267.[doi:10.7683/xxyxyxb.2023.03.013]
　TIAN Xiaoqin,SONG Linlin,QIN Yingxue.Analysis of risk factors of microangiopathy in type 2 diabetes mellitus patients[J].Journal of Xinxiang Medical University,2023,40(3):262-267.[doi:10.7683/xxyxyxb.2023.03.013]
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2型糖尿病患者并发微血管病变的危险因素分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年3期
页码:
262-267
栏目:
临床研究
出版日期:
2023-03-05

文章信息/Info

Title:
Analysis of risk factors of microangiopathy in type 2 diabetes mellitus patients
作者:
田晓琴; 宋琳琳; 秦迎雪
（聊城市中心医院内分泌科，山东　聊城　252000）
Author(s):
TIAN Xiaoqin; SONG Linlin; QIN Yingxue
（Department of Endocrinology,Liaocheng City Central Hospital,Liaocheng 252000,Shandong Province,China）
关键词:
2型糖尿病; 微血管病变; 同型半胱氨酸; D-二聚体; 血小板参数
Keywords:
type 2 diabetes mellitus; microangiopathy; homocysteine; D-dimer; platelet parameter
分类号:
R587.106
DOI:
10.7683/xxyxyxb.2023.03.013
文献标志码:
A
摘要:
目的观察2型糖尿病（T2DM）并发微血管病变患者血浆同型半胱氨酸（Hcy）、D-二聚体（D-D）及血小板参数的变化，探讨T2DM并发微血管病变的影响因素。
方法选择2020年1月至2022年1月聊城市中心医院收治的120例T2DM患者为研究对象（T2DM组），根据是否并发微血管病变将患者分为未并发微血管病变组（n=60）和并发微血管病变组（n=60）；另选择同期在聊城市中心医院体检的60例健康者作为健康对照组。3组受试者均于清晨抽取空腹静脉血，应用ABX-120全血细胞五分类分析仪检测平均血小板体积（MPV）、血小板体积分布宽度（PDW）、血小板压积（PCT）和血小板计数（PLT）等血小板参数，全自动血凝分析仪检测血浆D-D、纤维蛋白原（FIB）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）及凝血酶时间（TT）等血凝指标，糖化血红蛋白仪检测糖化血红蛋白（HbA1c）水平，血糖仪检测空腹血糖（FPG），全自动生物化学分析仪检测Hcy水平。比较健康对照组与T2DM组、未并发微血管病变组与并发微血管病变组受试者的血小板参数、血凝指标、HbA1c、FPG及Hcy水平。采用Pearson相关分析Hcy、凝血指标及血小板参数与FPG的相关性，多因素logistic回归分析T2DM并发微血管病变的危险因素。
结果T2DM组患者的MPV、PDW及Hcy、D-D、FIB、HbA1c、FPG水平显著高于健康对照组，PLT、PT、APTT及TT显著低于健康对照组（P<0.05）；T2DM组与健康对照组受试者的PCT比较差异无统计学意义（P>0.05）。并发微血管病变组患者的MPV及Hcy、D-D、FIB、HbA1c、FPG水平显著高于未并发微血管病变组，PLT、APTT显著低于未并发微血管病变组（P<0.05）；未并发微血管病变组与并发微血管病变组患者的PDW、PCT、PT和TT比较差异无统计学意义（P>0.05）。并发微血管病变患者的Hcy与FPG呈正相关（r=0.384，P<0.05），D-D与FPG呈负相关（r=-0.079，P<0.05），FIB、PT、APTT、TT、PLT、MPV、PDW、PCT与FPG无相关性（r=0.056、-0.368、-0.016、0.056、0.150、0.112、0.150、-0.077，P>0.05）。Logistic回归分析结果显示，Hcy、D-D、FIB、HbA1c及FPG是T2DM患者发生微血管病变的独立危险因素（P<0.05）。
结论与T2DM未并发微血管病变患者比较，T2DM并发微血管病变患者的PLT、APTT显著下降，MPV及Hcy、D-D、FIB、HbA1c、FPG水平显著升高；Hcy、D-D、FIB、HbA1c和FPG是T2DM并发微血管病变的独立危险因素，可作为早期判断T2DM并发微血管病变的指标。
Abstract:
ObjectiveTo observe the changes of plasma homocysteine (Hcy),D-dimer (D-D) and platelet parameters in type 2 diabetes mellitus (T2DM) patients with microangiopathy,and explore the influencing factors of microvascular disease in T2DM patients.MethodsA total of 120 patients with T2DM admitted to Liaocheng City Central Hospital from January 2020 to January 2022 were selected as the research objects(T2DM group),and the patients were divided into non-microangiopathy group (n=60) and microangiopathygroup (n=60) according to whether microangiopathy was complicated.In addition,60 healthy people who underwent physical examination in Liaocheng City Central Hospital in the same period were selected as the health control group.The fasting venous blood was taken from the subjects in the three groups in the morning,and the mean platelet volume (MPV),platelet volume distribution width (PDW),platelet crit (PCT),platelet count (PLT) were detected by ABX-120 whole-blood cell five-classification analyzer;the blood coagulation indexes including the plasma D-D,fibrinogen (FIB),prothrombin time (PT),activated partial thromboplastin time (APTT) and thrombin time (TT) were detected by automatic blood coagulation analyzer;glycosylated hemoglobin (HbA1c) level was detected by glycosylated hemoglobin meter;the fasting blood glucose (FPG) level was detected by blood glucose meter;and the Hcy level was detected by automatic biochemical instrument.The platelet parameters,blood coagulation indexes,HbA1c,FPG and Hcy levels of subjects between the healthy control group and T2DM group,the non-microangiopathy group and microangiopathy group were compared.The correlations between Hcy,coagulation indexes,platelet parameters and FPG were analyzed by Pearson correlation analysis.The risk factors of T2DM complicated with microangiopathy was analyzed by multifactor logistic regression analysis.ResultsThe levels of Hcy,D-D,FIB,HbA1c,FPG and MPV,PDW of patients in the T2DM group were significantly higher than those in the healthy control group,and the PLT,PT,APTT and TT were significantly lower than those in the healthy control group (P<0.05);there was no significant difference in PCT of the subjects between T2DM group and healthy control group (P>0.05).The levels of Hcy,D-D,FIB,FPG,HbA1c and MPV of patients in the microangiopathy group were significantly higher than those in the non-microangiopathy group,the PLT and APTT were significantly lower than those in the non-microangiopathy group (P<0.05);there was no significant difference in PDW,PCT,PT and TT of patients between the non-microangiopathy group and microangiopathy group(P>0.05).The Hcy of patients with microangiopathy was positively correlated with FPG (r=0.384,P<0.05),D-D was negatively correlated with FPG (r=-0.079,P<0.05);and FIB,PT,APTT,TT,PLT,MPV,PDW,PCT were not correlated with FPG (r=0.056,-0.368,-0.016,0.056,0.150,0.112,0.150,-0.077;P>0.05).Logistic regression analysis showed that Hcy,D-D,FIB,HbA1c and FPG were independent risk factors for microvascular disease in T2DM patients (P<0.05).ConclusionCompared with T2DM patients without microangiopathy,the PLT and APTT decreased significantly in T2DM patients with microangiopathy,the MPV and the levels of Hcy,D-D,FIB,MPV,HbA1c and FPG increased significantly;Hcy,D-D,FIB,HbA1c and FPG are the independent risk factors for microangiopathy in T2DM patients,which can be used as indicators for early diagnosis of microangiopathy in T2DM patients.

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更新日期/Last Update: 2023-03-05