【摘要】 目的 探讨糖尿病微血管病变患者体内血栓前体蛋白(TpP)浓度和抗凝血酶Ⅲ(AT-Ⅲ)活性改变及其与糖尿病合并脑梗死的关系。 方法 选取糖尿病微血管病变患者101例和正常对照(NC)者31例，观察各组TpP浓度、AT-Ⅲ活性变化及脑梗死发生的风险指标。 结果 与NC组相比，糖尿病微血管病变组TpP浓度高、AT-Ⅲ活性低[(5.53±3.16)vs(3.86±1.37)μg/ml，P<0.05]，[(92.26±13.97)% vs(102.24±10.45)%，P<0.05]。糖尿病微血管病变合并脑梗死亚组、糖尿病微血管病变未合并脑梗死亚组和NC组TpP浓度、AT-Ⅲ活性比较差异有统计学意义[(6.82±4.12)vs(4.88±2.32)vs (3.86±1.37) μg/ml，P<0.05;(86.21±13.47)% vs(95.33±13.30)% vs(102.24±10.45)%，P<0.05]。Logistic多元回归分析显示，年龄、SBP、TpP、AT-Ⅲ与脑梗死的发生独立相关(P<0.05)。 结论 糖尿病微血管病变组TpP浓度升高，AT-Ⅲ活性降低，糖尿病患者机体处于血栓前状态，存在血栓形成风险。糖尿病患者联合检测血浆TpP浓度和AT-Ⅲ活性的改变有助于血栓性疾病的早期发现及治疗。

　　【关键词】血栓前体蛋白;抗凝血酶Ⅲ;血栓前状态;糖尿病;糖尿病微血管病变

　　【Abstract】 Objective To investigate the relationship between the changes of thrombus precursor protein (TpP) concentrations and antithrombin Ⅲ (AT-Ⅲ) activity and the diabetic thrombotic complications. Methods 101 hosaipitalized patients with diabetic microangiopathy and 31 normal control (NC) people were selected. The differences of TpP concentrations and AT-Ⅲ activity were compared between two groups were compared. The relationship between the indexes and cerebral infarction was also statistically analyzed. Results Compared with NC group, serum TpP concentrations were significantly higher in diabetic microangiopathy group [(5.53±3.16)vs(3.86±1.37)μg/ml，P<0.05], and AT-Ⅲ activity were lower [(92.26±13.97)% vs(102.24±10.45)%，P<0.05]. There were statistical difference in serum TpP concentrations and AT-Ⅲ activity among diabetic cerebral infarction subgroup , diabetic not mergedwithout cerebral infarction subgroup and NC group [(6.82±4.12)vs(4.88±2.32)vs (3.86±1.37 ) μg/ml ，P<0.05;(86.21±13.47)%vs(95.33±13.30)%vs(102.24±10.45)% , P<0.05)]. Multiple logistic regression analysis showed that cerebral infarction was significantly associated with age, SBP, TpP and AT-Ⅲ (P<0.05). Conclusion The serum TpP levels are increased while AT-Ⅲ activity is declined. It means that there may be a pre-thrombotic status in patients with diabetic microangiopathy, which is risk for thrombosis. Combined detections of TpP and AT-Ⅲ may contribute to early diagnosis and treatment of thrombotic diseases for these patients.

　　【Key words】Thrombus precursor protein (TpP);Antithrombin-Ⅲ (AT-Ⅲ);Prethrombotic status;Diabetes mellitus;Diabetic microangiopathy