糖尿病大血管病变

　　[摘要] 目的探讨患者心血管并发症与T2DM平均血小板容积(MPV)的相关性及其临床价值。方法选取2013年5月至2014年5月T2DM患者98例，分为伴有心血管病变(T2DM+CVD组)组和单纯T2DM(T2DM组)组。另选取健康对照(NC)20名组。检测各组MPV、血小板分布宽度(PDW)、血小板压积(PCT)、血小板计数(PLT)和白细胞计数(WBC)、TC、TG、LDL-C、HDL-C、脂蛋白A、SUA和HbA1c等指标，并进行统计学分析。Logistic回归分析影响T2DM心血管病变并发症的因素;分析T2DM合并高血压、冠心病和脑梗死患者的血小板参数。结果 T2DM+CVD组37例，T2DM组44例。T2DM组SBP、DBP和TG均低于T2DM+CVD组[SBP(121.55±21.13)vs (136.33±12.47)mmHg;DBP(75.34±9.42)vs (86.42±9.47)mmHg;TG(1.84±1.24)vs(2.34±1.17)mmol/L](P<0.05)。T2DM+CVD组和T2DM组MPV及PDW与NC组比较均有不同程度的升高，而PLT降低(P<0.05)。Logistic回归分析显示，MPV和SBP是T2DM患者发生血管病变的危险因素，与T2DM新血管并发症有相关性。T2DM合并高血压患者血液中MPV值最高为(19.74±7.73)fl，T2DM合并冠心病患者血液中PDW最高为(25.95±4.99)%。结论 MPV与T2DM患者心血管并发症有相关性。

　　[关键词]糖尿病，2型;平均血小板容积;心血管并发症;糖尿病血管病变

　　[Abstract] Objective To investigate the correlation between the mean platelet volume (MPV) and cardiovascular disease complications in patients with type 2 diabetes mellitus and its clinical value. Methods All the study subjects were selected from type 2 diabetic patients admitted to our hospital form 2013 May to 2014 May. A total of 98 participants were divided into two groups: patients with cardiovascular disease group (T2DM+CD group) and patients without cardiovascular disease group (T2DM group). 20 healthy subjects were selected as normal control (NC). Mean platelet volume (MPV), platelet distribution width (PDW), platelet hematocrit (PCT), platelet count (PLT), white blood cell count (WBC), blood plasma TC,TG, LDL-C, HDL-C, lipoprotein a, UA and HbA1c were tested. Logistic regression analysis was used to analyze factors influencing cardiovascular complications in patients with type 2 diabetes mellitus and statistical analysis was undertaken to further analysis platelet parameters in type 2 diabetic patients with hypertension, coronary heart disease and cerbral infarction. Results There are 37 diabetic patients in T2DM+CVD group and 44 patients in T2DM group. SBP, DBP and TG were significantly lower in T2DM group than in T2DM+CVD group [SBP(121.55±21.13)vs (136.33±12.47)mmHg;DBP(75.34±9.42)vs (86.42±9.47)mmHg;TG(1.84±1.24)vs(2.34±1.17)mmol/L] (P < 0.05). Compared with the NC group, MPV and PDW in the T2DM+CVD group and T2DM group were significantly increased, although the extents varies, while PLT significantly decreased (P < 0.05). Logistic regression analysis showed that MPV and SBP were risk factors for vascular disease in type 2 diabetic patients. Maximal blood MPV value in type 2 diabetic patients with hypertension was (19.74 ± 7.73) fl, and maximal blood PDW value in type 2 diabetic patients with coronary heart disease was (25.95 ± 4.99)%.

　　Conclusion Mean platelet volume (MPV) is associated with cardiovascular complications in type 2 diabetic patients. .

　　[Key words] Mean platelet volume (MPV); Diabetes mellitus，type 2; Cardiovascular complications(CVD);Diabetic angiopathies