摘要
目的探讨糖尿病合并高血压患者凝血和纤维蛋白溶解及血液流变学指标的变化及临床意义。方法选取2019年1月至2020年5月火箭军特色医学中心收治的糖尿病合并高血压患者121例。依据合并高血压的分级分为1级高血压组(52例)、2级高血压组(40例)和3级高血压组(29例)。另选择同期本院诊治的40例未合并高血压的糖尿病患者为单纯糖尿病组。分别测定各组患者的凝血指标[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)],纤维蛋白溶解指标[D-二聚体、纤维蛋白原降解产物(FDP)、抗凝血酶Ⅲ、血管性血友病因子(vWF)]和血液流变学指标[全血黏度、血浆黏度、血细胞比容、红细胞沉降率(ESR)],并进行组间交叉比较。结果1级、2级、3级高血压组患者PT、TT、APTT明显短于单纯糖尿病组,FIB、D-二聚体、FDP、vWF水平明显高于单纯糖尿病组,抗凝血酶Ⅲ水平明显低于单纯糖尿病组,全血黏度[(6.38±0.62)、(6.69±0.81)、(7.18±0.77)mPa·s比(5.98±0.43)mPa·s]、血浆黏度、血细胞比容和ESR明显高于单纯糖尿病组,差异均有统计学意义(均P<0.05)。3级高血压组与1级、2级高血压组比较以上指标差异亦均有统计学意义(均P<0.05)。结论糖尿病合并高血压患者的凝血及纤维蛋白溶解功能存在明显异常、血黏度增大,其中合并3级高血压患者更明显。
Objective To discuss changes of coagulation,fibrinolysis and hemorheological indexes in patients with diabetes mellitus and hypertension and their clinical significance.Methods From January 2019 to May 2020,121 patients with diabetes mellitus and hypertension admitted to Rocket Force Characteristic Medical Center were enrolled.According to the classification of hypertension,they were divided into grade 1 hypertension group(52 cases),grade 2 hypertension group(40 cases)and grade 3 hypertension group(29 cases).Another 40 diabetic patients without hypertension in the same period were selected as simple diabetes group.The coagulation indexes[prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)],fibrinolysis indexes[D-dimer,fibrin degradation product(FDP),antithrombinⅢand von Willebrand factor(vWF)]and hemorheological parameters[whole blood viscosity,plasma viscosity,hematocrit and erythrocyte sedimentation rate(ESR)]of all groups were determined respectively,and were cross compared between groups.Results The PT,TT and APTT in grade 1,2 and 3 hypertension groups were significantly shorter than those in the simple diabetes group,the levels of FIB,D-dimer,FDP and vWF were significantly higher than those in the simple diabetes group,the level of antithrombinⅢwas significantly lower than that in the simple diabetes group,the whole blood viscosity[(6.38±0.62),(6.69±0.81),(7.18±0.77)mPa·s vs(5.98±0.43)mPa·s],plasma viscosity,hematocrit and ESR were significantly higher than those in the simple diabetes group,and the differences were statistically significant(all P<0.05).Compared with grade 1 and 2 hypertension groups,the differences of the above indexes in grade 3 hypertension group were also statistically signifficant(all P<0.05).Conclusions The coagulation and fibrinolysis function in patients with diabetes mellitus complicated with hypertension were significantly abnormal and blood viscosity increased.Among them,patients with grade 3 hypertension are more obvious
作者
李雅维
王爽
徐佩秋
陈俊臣
岳晶晶
Li Yawei;Wang Shuang;Xu Peiqiu;Chen Junchen;Yue Jingjing(Medical Examination Center,Rocket Force Characteristic Medical Center,Beijing 100088,China;Department of Endocrinology,Rocket Force Characteristic Medical Center,Beijing 100088,China;Department of Internal Medicine,Rocket Force Characteristic Medical Center,Beijing 100088,China)
出处
《中国医药》
2021年第12期1799-1802,共4页
China Medicine
关键词
糖尿病
高血压
凝血
纤维蛋白溶解
血液流变学
Diabetes mellitus
Hypertension
Coagulation
Fibrinolysis
Haemorheology
