摘要
目的探讨糖耐量减低（IGT）患者是否具有与糖尿病患者相似的血栓前状态，这种血栓前状态的影响因素，及此异常与心血管疾病危险性是否相关。方法将患者分为对照组20例，IGT组38例，糖尿病不合并冠心病组20例（糖尿病组），糖尿病合并冠心病组31例。采用酶联免疫吸附（ELISA）法检测vW因子（vWF）、凝血酶调节蛋白（TM）、蛋白C活性、蛋白C含量、蛋白S含量、纤溶酶原激活物抑制物-1（PAI-1）。结果①IGT组vWF、蛋白C活性及PAI—1较对照组显著升高（均P〈0．01）。②IGT组患者血栓前状态的影响因素与糖尿病组患者的影响因素不甚一致。③IGT组与糖尿病、糖尿病合并冠心病组之间vWF、蛋白C活性的差异无统计学意义（均P〉0．05）；PAI-1在各组之间差异有统计学意义（P〈0．05）。结论①IGT作为糖尿病的前驱阶段，已经存在血栓前状态。②IGT的血栓前状态的影响因素与糖尿病相比具有相似性，这反映了IGT发展为糖尿病过程的某种连续性。与此同时，IGT的血栓前状态也有不同于糖尿病的特点。⑧这些血栓前状态方面的异常可能与糖尿病具有相类似的致心血管疾病的危险性。
Objective To study the prothrombotic state ,the factors leading to this status,and its relationship with the risk of cardiovascular disease in impaired glucose tolerance（IGT） patients. Methods The patients were divided into 4 groups： ①20 control subjects,②38 patients with IGT,③20 patients with diabetes only, ④31 with diabetes and coronary heart disease. The vWF, throbomodulin, protein C, protein S, plasminogen activator inhibitor 1 were measured by ELISA. Results①There was statistical difference between IGT and controls in vWF,activity of PC and PAI-1 （P 〈0.01 ,respectively）. ②There were different factors that probably lead to the prothrombotic status among patients with IGT and diabetes. ③There were statistical differences among IGT,diabetes and diabetes with coronary heart disease in vWF,activity of Protein C. There were statistical difference among IGT ,diabetes and diabetes with Coronary heart disease in PAI-1 （P 〈 0.05,respectively）. Conclusion ①There is the prothrombotic status in the patients with IGT,similarly to those with diabetes. ②IGT has the similar prothrombotic status as diabetes,So IGT could be considered as the prodromal stage of diabetes ,because of some continuity in the progress. Meanwhile,it still has some different specialties. ③The abnormality of the system of endothelium,anti-coagulation and fibrolysis in the patients of IGT is similar to those with diabetes. These variations might have the similar risk of cardiovascular disease with the diabetes.
出处
《中国综合临床》
北大核心
2008年第11期1121-1124,共4页
Clinical Medicine of China
