摘要
目的通过血栓弹力图检测2型糖尿病患者在不同血尿酸水平下的凝血功能状态。方法选取2016年2月至2017年12月南京医科大学第二附属医院内分泌科住院的2型糖尿病患者208例，根据血尿酸水平，分为血尿酸正常组（108例）和高尿酸血症组（HUA组，100例）；另选健康体检者102名为正常对照组（NC组），均予以血栓弹力图、血脂、肾功能、常规凝血功能等检测。血尿酸与血栓弹力图参数的相关性采用Peanon偏相关分析。结果与正常对照组相比，血尿酸正常组及HUA组均呈现高凝趋势，表现为反应时间（R）、凝固时间（K）明显降低（F=29．30、12．63，P均〈0．001），凝固角（ande）、最大振幅（MA）、纤维蛋白原升高（F=12．52、13．63、13．23，P均〈0．001）；与血尿酸正常组相比，HUA组的K较低，an亩e、MA、纤维蛋白原较高（P均〈0．05）。进一步对HUA组分别以性别及尿酸中位数分为4组，结果显示，与A1组（男〈440．5μmol／L）相比，A2组（男≥440．5μmol／L）R、K降低，angle、MA升高（t=3．46、2．29、-2．52、-2．34，P均〈0．05）；与B1组（女〈452．5μmoL／L）相比，B2组（女≥452．5μmol／L）K降低，ande、MA升高（t=2．56、-2．32、-2．07，P均〈0．05）。各组间血小板计数差异无统计学意义。Pearson偏相关分析显示，在控制了年龄、性别、肌酐、总胆固醇、甘油三酯、高密度脂蛋白-胆固醇、低密度脂蛋白一胆固醇、高血压、冠心病、脑梗死等因素后，血尿酸与R、K呈负相关（r=-0．199、-0．284，P均〈0．05），与angle、MA呈正相关（r=0．269、0．347，P均〈0．01）。结论2型糖尿病患者存在高凝状态，血尿酸可能与2型糖尿病患者高凝状态相关。
Objective To detect the coagulation status of type 2 diabetic patients with different lev- els of serum uric acid by thrombelastogram. Methods A total of 208 inpatients with type 2 diabetes, from the Department of Endocrinology of the Second Affiliated Hospital of Nanjing Medical University from Febru- ary 2016 to December 2017, were divided into normal serum uric acid group （ n = 108 ） and hyperuricemia group （HUA group, n = 100） according to their serum uric acid level. Another 102 healthy subjects were selected as normal control group （ NC group）. The thrombe｜astogram as well as serum lipid, renal function and conventional coagulation etc were tested. The correlation of serum uric acid and thrombelastogram pa- rameters was analyzed by Pearson partial correlation analysis. Results Compared with NC group, both nor- mal serum uric acid group and HUA group showed a hypercoagulable tendency, including a decrease in reac- tion time （R） , coagulation time （K） （ F = 29.30, 12.63, all P 〈 0.001 ） , and an increase in angle, maxi- mum amplitude （ MA）, and fibrinogen （F = 12.52, 13.63, 13.23, all P 〈 0.001 ）. Compared with normal uric acid group, K in HUA group was lower, whereas angle, MA and fibrinogen were higher （all P 〈 0.05 ）. HUA group was further divided into four groups according to gender and uric acid level. The re- suits showed that compared with A1 group （ male 〈 440.5 μmol/L）, R and K were decreased, and angleandMA were increased in A2 group （male≥440.5 μmol/L, t--3.46, 2.29, -2.52, -2.34, all P 〈 0.05 ）. Compared with B1 group （female 〈 452.5 μmol/L） , K was decreased, angle and MA were in- creased in B2 group （female ≥452.5 μmoL/L, t = 2.56, - 2.32, - 2.07, all P 〈 0.05 ）. There were no statistically significant differences in platelet counts in all groups. Pearson partial correlation analysis re- vealed that serum uric acid was negatively correlated with R and K （r = -0. 199, -0. 284, all P 〈 0.05 ） , and positively correla
作者
安秀敏
蔡婷婷
缪珩
An Xiumin;Cai Tingting;Miao Heng(Department of Endocrinology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China)
出处
《国际内分泌代谢杂志》
2018年第4期217-221,共5页
International Journal of Endocrinology and Metabolism
关键词
2型糖尿病
高尿酸血症
血栓弹力图
高凝状态
Type 2 diabetes mellitus
Hyperuricemia
Thrombelastogram
Hypercoagulability
