2型糖尿病合并高血压患者血浆D-二聚体及纤维蛋白原水平研究
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摘要
目的
研究2型糖尿病合并高血压患者与2型糖尿病患者血浆D-二聚体(D-dimer)及纤维蛋白原(Fibrinogen)的不同。
方法
将85例研究对象分为三组:①正常对照组:20例;②无高血压的2型糖尿病组:21例;③2型糖尿病合并高血压组:44例。为了进一步探讨在2型糖尿病患者中血压水平与D-二聚体及纤维蛋白原的相关性,将2型糖尿病合并高血压组分为三亚组:①1级高血压:收缩压在140—159 mmHg或舒张压在90—99mmHg之间:16例;②2级高血压:收缩压在160—179mmHg或舒张压在100—109mmHg之间:14例;③3级高血压:收缩压≥180mmHg或舒张压≥110mmHg:14例。分别测定其血浆D-二聚体和纤维蛋白原水平并比较组间差异,检测结果数据以均数±标准差((?)±s)表示,组间比较采用ANOVA方差检验(使用SPSS13.0软件)。
结果
D-二聚体检测:无高血压的2型糖尿病组与正常对照组相比,D-二聚体水平明显升高,有统计学差异(P＜0.05);2型糖尿病合并高血压组与对照组相比,D-二聚体水平也明显升高,有显著性差异(P＜0.01):无高血压的2型糖尿病组与合并高血压组也有统计学差异(P＜0.05)。纤维蛋白原检测:无高血压的2型糖尿病组与正常对照组相比,纤维蛋白原水平明显升高,有统计学差异(P＜0.05);2型糖尿病合并高血压组与对照组相比,纤维蛋白原水平升高,有显著差异(P＜0.01):无高血压的2型糖尿病组与合并高血压组也有统计学差异(P＜0.05)。在血压水平亚组分析中:3级高血压组与1级高血压组在D-二聚体水平上有统计学差异(P＜0.05),在纤维蛋白原水平上有显著差异(P＜0.01)而其他组间无统计学差异。
结论
血浆D-二聚体及纤维蛋白原水平在2型糖尿病及合并高血压患者中明显升高,这可能与凝血和纤溶系统失衡相关,在2型糖尿病及合并高血压患者中监测血浆D-二聚体及纤维蛋白原水平可能对于预防血栓性疾病有重要的临床意义。
Objective
To evaluate the plasma D-dimer and fibrinogen level in the patients of type 2 diabetes mellitus with hypertension and investigate their correlation.
Method
85 subjects were divided into three groups according to clinical manifestation:①control group:20 subjects;②type 2 diabetes mellitus group:21 subjects;③type 2 diabetes mellitus combined with hypertension group:44 subjects.To further investate the relationship between the blood pressure and plasma level of D-dimer or fibrogen in the diabetetic hypertension patients,we also divide the group3 into three subgroup:ⅰ.stage 1 hypertension(SBP:140-159 mmHg or DBP:90-99mmHg)group:16 subjects;ⅱ.stage 2 hypertension(SBP:160-179mmHg or DBP:100-109mmHg) group:14 subjects;ⅲ.stage 3 hypertension(SBP≥180mmHg or DBP≥110mmHg)group:14 subjects;We measure the plasma D-dimer and fibrinogen level of each group,and compare between groups.The results were show as(?)±s,and we use ANOVA Test for comparing(SPSS 13.0).
Results
D-dimer:plasma concentrations was higher in single type 2 diabetes mellitus than those in normal control cases(P＜0.05):and in type 2 diabetes mellitus combined with hypertension cases had obvious difference(P＜0.01);and between single type 2 diabetes mellitus and type 2 diabetes mellitus combined with hypertension cases,the plasma concentrations of D-D was also higher than controls(P＜0.05).Fibrinogen: plasma concentrations was higher in single type 2 diabetes mellitus than those in normal control cases(P＜0.05);and in type 2 diabetes mellitus combined with hypertension cases had obvious difference(P＜0.01);and between single type 2 diabetes mellitus and type 2 diabetes mellitus combined with hypertension cases,the plasma concentrations of fibrinogen was also higher than controls(P＜0.05). subgroup:the plasma level of D-dimer and fibrinogen of stage 3 hypertension was significantly higher than stage 1 hypertension group.There were no obvious difference between other groups.
Conclusion
The plasma levels of D-dimer and fibrinogen were related to type 2 diabetes mellitus with hypertension,had difference in different level of hypertension,they may play an important roles in forecast and diagnosis.for thrombosis diseases.
研究2型糖尿病合并高血压患者与2型糖尿病患者血浆D-二聚体(D-dimer)及纤维蛋白原(Fibrinogen)的不同。
方法
将85例研究对象分为三组:①正常对照组:20例;②无高血压的2型糖尿病组:21例;③2型糖尿病合并高血压组:44例。为了进一步探讨在2型糖尿病患者中血压水平与D-二聚体及纤维蛋白原的相关性,将2型糖尿病合并高血压组分为三亚组:①1级高血压:收缩压在140—159 mmHg或舒张压在90—99mmHg之间:16例;②2级高血压:收缩压在160—179mmHg或舒张压在100—109mmHg之间:14例;③3级高血压:收缩压≥180mmHg或舒张压≥110mmHg:14例。分别测定其血浆D-二聚体和纤维蛋白原水平并比较组间差异,检测结果数据以均数±标准差((?)±s)表示,组间比较采用ANOVA方差检验(使用SPSS13.0软件)。
结果
D-二聚体检测:无高血压的2型糖尿病组与正常对照组相比,D-二聚体水平明显升高,有统计学差异(P＜0.05);2型糖尿病合并高血压组与对照组相比,D-二聚体水平也明显升高,有显著性差异(P＜0.01):无高血压的2型糖尿病组与合并高血压组也有统计学差异(P＜0.05)。纤维蛋白原检测:无高血压的2型糖尿病组与正常对照组相比,纤维蛋白原水平明显升高,有统计学差异(P＜0.05);2型糖尿病合并高血压组与对照组相比,纤维蛋白原水平升高,有显著差异(P＜0.01):无高血压的2型糖尿病组与合并高血压组也有统计学差异(P＜0.05)。在血压水平亚组分析中:3级高血压组与1级高血压组在D-二聚体水平上有统计学差异(P＜0.05),在纤维蛋白原水平上有显著差异(P＜0.01)而其他组间无统计学差异。
结论
血浆D-二聚体及纤维蛋白原水平在2型糖尿病及合并高血压患者中明显升高,这可能与凝血和纤溶系统失衡相关,在2型糖尿病及合并高血压患者中监测血浆D-二聚体及纤维蛋白原水平可能对于预防血栓性疾病有重要的临床意义。
Objective
To evaluate the plasma D-dimer and fibrinogen level in the patients of type 2 diabetes mellitus with hypertension and investigate their correlation.
Method
85 subjects were divided into three groups according to clinical manifestation:①control group:20 subjects;②type 2 diabetes mellitus group:21 subjects;③type 2 diabetes mellitus combined with hypertension group:44 subjects.To further investate the relationship between the blood pressure and plasma level of D-dimer or fibrogen in the diabetetic hypertension patients,we also divide the group3 into three subgroup:ⅰ.stage 1 hypertension(SBP:140-159 mmHg or DBP:90-99mmHg)group:16 subjects;ⅱ.stage 2 hypertension(SBP:160-179mmHg or DBP:100-109mmHg) group:14 subjects;ⅲ.stage 3 hypertension(SBP≥180mmHg or DBP≥110mmHg)group:14 subjects;We measure the plasma D-dimer and fibrinogen level of each group,and compare between groups.The results were show as(?)±s,and we use ANOVA Test for comparing(SPSS 13.0).
Results
D-dimer:plasma concentrations was higher in single type 2 diabetes mellitus than those in normal control cases(P＜0.05):and in type 2 diabetes mellitus combined with hypertension cases had obvious difference(P＜0.01);and between single type 2 diabetes mellitus and type 2 diabetes mellitus combined with hypertension cases,the plasma concentrations of D-D was also higher than controls(P＜0.05).Fibrinogen: plasma concentrations was higher in single type 2 diabetes mellitus than those in normal control cases(P＜0.05);and in type 2 diabetes mellitus combined with hypertension cases had obvious difference(P＜0.01);and between single type 2 diabetes mellitus and type 2 diabetes mellitus combined with hypertension cases,the plasma concentrations of fibrinogen was also higher than controls(P＜0.05). subgroup:the plasma level of D-dimer and fibrinogen of stage 3 hypertension was significantly higher than stage 1 hypertension group.There were no obvious difference between other groups.
Conclusion
The plasma levels of D-dimer and fibrinogen were related to type 2 diabetes mellitus with hypertension,had difference in different level of hypertension,they may play an important roles in forecast and diagnosis.for thrombosis diseases.
引文
[1]Freed,The hatemostasis epidemiologist' s view[J].Ital Heart.2001,9:656-657.
[2]Lip GY,Lowe GD.Fibrin D-dimer:a useful clinical marker of thrombogenesis[J].Clin Sci,1995,89(3):205.
[3]Engels,Evans SP,MikkM,et al.D- dimer in the elderly diagnosis of thromboebolic disease in acute spinal injuries[J].Med J,Aust,1993,158:705.
[4]Lehmann R,Schleiher ED.Molecular mechanism of diabetic nephropathy [J].Clin Chin Acta,2000,297(1):135-144.
[5]GD Lowe.How to search for the role and prevalence of defective fibrinolytic states as triggers of myocardial infarction? The haemostasis epidemiologist's view[J].Ital Heart J,Sep 2001;2(9):656-657.
[6]Knobl P,Schemt haner G,Schnack C,et al.Haemostatic abnormalities persist despite glycaemic improvement by insulin therapy in lean type 2 diabetic patients[J].Thromb Haemost,1994,71(6):692-697.
[7]ZF Long,GY Qu,and M Xu Relationship between the level of plasma D-dimer and diabetic microangiopathy[J].Hunan Yi Ke Da Xue Xue Bao,Oct 2001;26(5):434-6.
[8]E Coban,R Sari,M Ozdogan,and F Akcit.Levels of plasma fibrinogen and D-dimer in patients with impaired fasting glucose[J].Exp Clin Endocrinol Diabetes,Jan 2005;113(1):35-7.
[9]Yamada T,Sato A,Nishimori T.Importance of hypercoagulability over hyperglycemia for vascular complication in type 2-diabetes[J].Diabetes ResClin Pratt,2000,49(1):23-31.
[10]Kloczko J,Naqvi T,Waite M,et al.Von Willebrand factor and tigen and fibronection in essential hypertension[J].Thromb Res,1995,79:331.
[11]St.Jone SytonM,Thogersen AM,Reeven G,etal.Diabetes and essential hypertension[J].Diabetes Care,2002,25,2058-2064
[12]Rait,Devidson M,Freed M,etal.Relation diabetes and hypertension[J].Diabetes Care,2003,26(1):172-178
[13]VaziriND,Smith DH,Winer RL,et al.Coagulation and inhibitory and fibrinolytic proteins in essential hypertension[J].Am Soc Nephed,1993,4:222.
[14]杨文.高血压病患者血浆纤维蛋白原和D-二聚体的测定.心肺血管病杂 志,2001 ;20 (1) :20
[15]Wolfgang Koenig, Dietrich Rothenbacher, Albrecht Hoffmeister, Martin Griesshammer, and Hermann Brenner.Plasma Fibrin D-Dimer Levels and Risk of Stable Coronary Artery Disease: Results of a Large Case-Control Study[J].Arterioscler. Thromb. Vasc. Biol., Oct 2001; 21: 1701 - 1705
[16] Al Soares, Mde O Sousa, LM Dusse, AP Fernandes,Type 2 diabetes: assessment of endothelial lesion and fibrinolytic system markers.Blood Coagul Fibrinolysis, July 1,2007; 18(5): 395-9.
[17] Martin PV , Vadillo J , Diaz J,etal.Fibrinogen and fibrinolysis in blood and in the arterial wall: Its role in advanced athero sclerotic disease Cardiovascular Surg, 1998; 6 (5): 457.
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[2]Lip GY,Lowe GD.Fibrin D-dimer:a useful clinical marker of thrombogenesis[J].Clin Sci,1995,89(3):205.
[3]Engels,Evans SP,MikkM,et al.D- dimer in the elderly diagnosis of thromboebolic disease in acute spinal injuries[J].Med J,Aust,1993,158:705.
[4]Lehmann R,Schleiher ED.Molecular mechanism of diabetic nephropathy [J].Clin Chin Acta,2000,297(1):135-144.
[5]GD Lowe.How to search for the role and prevalence of defective fibrinolytic states as triggers of myocardial infarction? The haemostasis epidemiologist's view[J].Ital Heart J,Sep 2001;2(9):656-657.
[6]Knobl P,Schemt haner G,Schnack C,et al.Haemostatic abnormalities persist despite glycaemic improvement by insulin therapy in lean type 2 diabetic patients[J].Thromb Haemost,1994,71(6):692-697.
[7]ZF Long,GY Qu,and M Xu Relationship between the level of plasma D-dimer and diabetic microangiopathy[J].Hunan Yi Ke Da Xue Xue Bao,Oct 2001;26(5):434-6.
[8]E Coban,R Sari,M Ozdogan,and F Akcit.Levels of plasma fibrinogen and D-dimer in patients with impaired fasting glucose[J].Exp Clin Endocrinol Diabetes,Jan 2005;113(1):35-7.
[9]Yamada T,Sato A,Nishimori T.Importance of hypercoagulability over hyperglycemia for vascular complication in type 2-diabetes[J].Diabetes ResClin Pratt,2000,49(1):23-31.
[10]Kloczko J,Naqvi T,Waite M,et al.Von Willebrand factor and tigen and fibronection in essential hypertension[J].Thromb Res,1995,79:331.
[11]St.Jone SytonM,Thogersen AM,Reeven G,etal.Diabetes and essential hypertension[J].Diabetes Care,2002,25,2058-2064
[12]Rait,Devidson M,Freed M,etal.Relation diabetes and hypertension[J].Diabetes Care,2003,26(1):172-178
[13]VaziriND,Smith DH,Winer RL,et al.Coagulation and inhibitory and fibrinolytic proteins in essential hypertension[J].Am Soc Nephed,1993,4:222.
[14]杨文.高血压病患者血浆纤维蛋白原和D-二聚体的测定.心肺血管病杂 志,2001 ;20 (1) :20
[15]Wolfgang Koenig, Dietrich Rothenbacher, Albrecht Hoffmeister, Martin Griesshammer, and Hermann Brenner.Plasma Fibrin D-Dimer Levels and Risk of Stable Coronary Artery Disease: Results of a Large Case-Control Study[J].Arterioscler. Thromb. Vasc. Biol., Oct 2001; 21: 1701 - 1705
[16] Al Soares, Mde O Sousa, LM Dusse, AP Fernandes,Type 2 diabetes: assessment of endothelial lesion and fibrinolytic system markers.Blood Coagul Fibrinolysis, July 1,2007; 18(5): 395-9.
[17] Martin PV , Vadillo J , Diaz J,etal.Fibrinogen and fibrinolysis in blood and in the arterial wall: Its role in advanced athero sclerotic disease Cardiovascular Surg, 1998; 6 (5): 457.
[1]peter Gade,Pernille Vedel,Nicolai Larsen,etal.Multifactorial Intervention and Cardiovascular Disease in Patients with Type 2 Diabetes[J]N.Engl.J.Med.,2003;348:383-393.
[2]M Fisher.Diabetes:can we stop the time bomb?[J]Heart,2003;89:28.
[3]Hae Mi Choe,Kevin A.Townsend,Gretchen Blount,etal.Treatment and control of blood pressure in patients with diabetes mellitus[J]Am.J.Health Syst.Fharm,2007;64:97-103.
[4]Gang Hu,Cinzia Sarti,Fekka Jousilahti,etal.The Impact of History of Hypertension and Type 2 Diabetes at Baseline on the Incidence of Stroke and Stroke Mortality[J].Stroke,2005;36:2538-2543.
[5]Daniel M.Riche and Katie S.McClendon.Role of statins for the primary prevention of cardiovascular disease in patients with type 2 diabetes mellitus[J].Am.J.Health Syst.Pharm,2007;64:1603-1610.
[6]Jarnes R.Sowers.Insulin resistance and hypertension[J].Am J Physiol Heart Circ Physiol, 2004;286:H1597-H1602.
[7] Undurti N. Das .Risk of type 2 diabetes mellitus in those with hypertension [J].Eur. Heart J, 2008; 10.1093/eurheartj/ehn037.
[8] Deborah K. Plante and Jerry L. Nadler. Diabetes and Vascular Disease[J]. Seminars in Cardiothoracic and Vascular Anesthesia, 2003; 7: 295 - 310.
[9]Cayatte AJ, Palacino JJ, Horten K, et al. Chronic inhibition of nitric oxide production accelerates neointima formation and impairs endothelial function in hypercholesterolemic rabbits [J]. Arteriosclerosis and thrombosis A journal of vascular biology, 1994; 14(5): 753—759.
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