[摘要] 目的 观察老年T2DM大血管病变患者凝血功能的改变和评估血栓弹力图(TEG) 在其凝血功能障碍中的作用。 方法　将60例老年T2DM患者分为单纯T2DM(T2DM组)和T2DM合并大血管病变(T2DM+MVC组)组。另选健康对照(NC组)组30名。各组均行常规凝血功能和TEG 检测。 结果 常规凝血功能检测显示，与NC组比较，T2DM组[(3.79±0.75)vs(3.36±0.91)g/L]和T2DM+MVC组[(4.27±1.06)vs(3.36±0.91)g/L]维蛋白原(FIB)均升高(P<0.05),且T2DM+MVC组高于T2DM组(P<0.05)。TEG检测显示，与NC组比较，T2DM组R值[(6.31±0.94)vs(5.74±0.88)min]缩短(P<0.05);T2DM+MVC组R值[(6.31±0.94)vs(4.76±1.27)min]和K值[(2.31±0.24)vs(1.64±0.62)min]明显缩短(P<0.01)，Angle角 [(60.61±4.75)vs(67.40±7.77)deg变大(P<0.01)。结论 老年老年T2DM大血管病变患者存在凝血功能紊乱。TEG 指标能反映该类患者的凝血功能障碍。

　　[关键词] 血栓弹力图;糖尿病，2型;大血管病变

　　[Abstract] Objective To explore blood coagulation changes and to evaluate the role of thromboelastography (TEG) in older type 2 diabetic patients with macrovascular disease. Methods 　A total of 60 older diabetic patients were divided into two groups according to their macrovascular complications: 30 cases with macroangiopathy (T2DM+MVC group), 30 cases without macroangiopathy(T2DM group) and another 30 healthy persons were selected as control group ( NC group). TEG and regular coagulation function were tested. Results Compared with NC group, the levels of serum FIB were higher in T2DM group [(3.79±0.75) vs (3.36±0.91)g/L] and T2DM+MVC group [(4.27±1.06) vs (3.36±0.91)g/L](P<0.05), and it was much higher in T2DM+MVC group than in T2DM group(P<0.05). TGE test showed that compared with NC group, TEG reaction time (R value) [(6.31±0.94) vs (5.74±0.88)min] was significantly shorter in T2DM group (P<0.05), R value [(6.31±0.94)vs(4.76±1.27)min] and K value [(2.31±0.24)vs(1.64±0.62)min] were also significantly shorter in T2DM+MVC group, but Angle α value [(60.61±4.75) vs (67.40±7.77) deg] was larger (P<0.01).Conclusion Blood coagulation function disorders exist in older diabetic patients with diabetic macroangiopathy. TEG indexes can reflect coagulation abnormalities in those patients.

　　Key words: Thrombelastography; Diabetes mellitus, type 2; macroangiopathy