·糖尿病临床研究·

　　【摘要】 目的 探讨检测T2DM患者血浆可溶性血栓调节蛋白(sTM)和D-二聚体(D-dimer)水平的临床意义。 方法 将41例进行冠状动脉造影的T2DM患者分为无冠脉病变组(A组，n=10)和有冠脉病变组(B组，n=31)。另选取体检健康者19名作为对照(NC)组。Gensini评分系统进行冠脉病变严重程度的评价，测定血浆sTM水平和D-dimer水平。 结果 A、B组与NC组比较,sTM和 D-dimer水平升高(P<0.05);且B组高于A组(P<0.05)。Spearman相关分析示sTM和D-dimer均与Gensini积分有显著相关性(r=0.277，P<0.01;r=0.393，P<0.01)。有序结果的累积比数Logistic回归示D-dimer的OR=2.14(Z=2.86, P=0.004)，sTM的OR=1.88(Z=2.06, P=0.043)。 结论 T2DM患者体内血浆sTM和D-dimer的表达升高，且与T2DM患者的大血管病变呈正相关。

　　【关键词】 糖尿病，2型;可溶性血栓调节蛋白;D-二聚体;大血管病变

Change of the serum sTM and D-dimer levels in T2DM patients and its clinical significance CHEN Jing, LI Shan-shan, WU Dong-hong, et al. Department of Endocrinology, The First Hospital of Harbin, Harbin 150010, China

Corresponding author: WU Dong-hong, E-mail: Wudonghong160@126.com

　　【Abstract】 Objective To evaluate the clinical significance of soluable thrombomodulin (sTM) and D-dimer levels in T2DM patients. Methods The 41 T2DM patients operated on coronary artery angiography were divided into non-CAS group (Group A, n=10) and CAS group (Group B, n=31), and 19 normal control subjects were in the control group. The extent of coronary atherosclerosis (CAS) was assessed using the Gensini scoring system. Levels of sTM were measured with an ELISA and D-dimer with immunizing nephelometry in serum samples. Results Compared with the control group, Group A and B had significantly higher levels of sTM and D-dimer (P<0.05) and the levels of sTM and D-dimer in Group B were significantly higher than those in Group A (P<0.05). Gensini’s score was significantly correlated to sTM and D-dimer (r=0.277, P<0.01; r=0.393, P<0.01). In an ordinal Logistic regression, the OR value of D-dimer was 2.14 (Z=2.86, P=0.004) and that of sTM was 1.88 (Z=2.06, P=0.043). Conclusions The expressions of serum sTM and D-dimer are elevated, and they are positively related with the diabetes macrovascular disease of T2DM patients.

　　【Key words】 Diabetes mellitus, type 2; Soluable thrombomodulin (sTM); D-dimer; Macrovascular disease