CAJ | 학술논문

目的：探讨血小板相关参数和血栓弹力图各指标与糖尿病血管并发症发生、发展的关系，以期尽早发现糖尿病血管并发症高危人群或早期患者。方法根据世界卫生组织关于糖尿病的诊断标准，选取268例患者和80例退休体检者（正常对照组）作为研究对象。将268例患者分为A组 HbA1c＜6．2％且无血管并发症者；B组 HbA1c＞6．5％且无血管并发症者和C组HbA1c＞8．0％且有血管并发症者。采用西门子公司ADVIA2120全自动血液分析仪测定血小板平均体积（M PV ）、血小板分布宽度（PDW ）、大血小板（L-PL T ）、平均血小板内容物含量（M PM ）和平均血小板内容物浓度（M PC ）等血小板参数；用 T EG＠5000凝血分析仪做血栓弹力图分析，检测R值、K值、Angle角和MA值并进行统计学分析。结果 B组L-PLT及C组血小板各参数与正常对照组比较差异有统计学意义（P＜0．05）。B组R值、K值、Angle角及C组R值、K值、Angle角、MA值与正常对照组比较差异有统计学意义（P＜0．05）。结论血小板相关参数和血栓弹力图检测对帮助糖尿病血管病变的临床诊断，治疗指导和病情监测有重要的意义；血栓弹力图在早期发现糖尿病血管病变患者上比血小板相关参数检测更敏感。
목적：탐토혈소판상관삼수화혈전탄력도각지표여당뇨병혈관병발증발생、발전적관계，이기진조발현당뇨병혈관병발증고위인군혹조기환자。방법근거세계위생조직관우당뇨병적진단표준，선취268례환자화80례퇴휴체검자（정상대조조）작위연구대상。장268례환자분위A조 HbA1c＜6．2％차무혈관병발증자；B조 HbA1c＞6．5％차무혈관병발증자화C조HbA1c＞8．0％차유혈관병발증자。채용서문자공사ADVIA2120전자동혈액분석의측정혈소판평균체적（M PV ）、혈소판분포관도（PDW ）、대혈소판（L-PL T ）、평균혈소판내용물함량（M PM ）화평균혈소판내용물농도（M PC ）등혈소판삼수；용 T EG＠5000응혈분석의주혈전탄력도분석，검측R치、K치、Angle각화MA치병진행통계학분석。결과 B조L-PLT급C조혈소판각삼수여정상대조조비교차이유통계학의의（P＜0．05）。B조R치、K치、Angle각급C조R치、K치、Angle각、MA치여정상대조조비교차이유통계학의의（P＜0．05）。결론혈소판상관삼수화혈전탄력도검측대방조당뇨병혈관병변적림상진단，치료지도화병정감측유중요적의의；혈전탄력도재조기발현당뇨병혈관병변환자상비혈소판상관삼수검측경민감。
Objective To investigate the relationship between the relevant platelet parameters and the thromboelastographic in-dexes with the the occurrence and development of diabetic vascular complications so as to early find the high-risk group of vascular complications or early patients .Methods According to the WHO diagnostic criteria for diabetes ,268 patients with diabetes and 80 retired people with the physical examination (normal control group) were selected as the research subjects .268 cases were divided into the group A(HbA1c <6 .2% without vascular complications) the group B(HbA1c >6 .5% without vascular complications) and the group C(HbA1c >8 .0% with vascular complications ) .The Siemens ADVIA2120 fully automatic blood analyzer was adopt-ed to detect the platelet parameters of mean platelet volume (MPV) ,platelet distribution width(PDW) ,large-platelet(L-PLT) , MPM and mean platelet concentration(MPC);The TEG@ 5000 coagulation analyzer was adopted to perform the thromboelastogra-phy for detecting the values of R ,K ,Angle A and MA .All obtained data were statistically analyzed .Results L-PLT in the group B and the platelet parameters in the group C had statistical differences compared with the normal control group (P<0 .05) .The val-ues of R ,K ,Angle A in the group B and the values of R ,K ,Angle A and Ma in the group C had statistical differences compared with the normal control group (P<0 .05) .Conclusion Relevant platelet parameters and the thrombelastogram detection have the important significance to help to the clinical diagnosis of diabetic angiopathy ,guide the treatment and the condition monitoring ;the thrombelastogram is more sensitive than the detection of the relevant platelet parameters in early finding the patients with diabetic angiopathy .