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目的探讨2型糖尿病(T2DM)患者血压波动与血栓前状态的关系。方法观察T2DM患者(糖尿病组,121例)和健康志愿者(对照组,119例)24-h血压、白天和夜间血压变异性,并检测血浆血管性假性血友病因子(vWF)、血小板α颗粒膜蛋白140(GMP-140)、纤维蛋白原(FG)、D-二聚体、纤溶酶原激活物抑制物1(PAI-1)和组织纤溶酶原激活物(t-PA)。比较两组血压变异性与血栓前状态指标,并进行相关性分析。结果糖尿病组24-h收缩压、白天收缩压、夜间收缩压变异性均高于对照组(P<0.05),糖尿病组vWF、D-二聚体和PAI-1高于对照组(P<0.05)。糖尿病组24-h收缩压变异性与vWF和GMP-140呈正相关(r分别为0.713和0.624,P<0.05);24-h以及夜间舒张压变异性与GMP-140呈正相关(r分别为0.638和0.634,P<0.05)。结论 T2DM患者的血压变异性显著增高,并伴有血管内皮损害、血小板和凝血纤溶系统的激活。
Objective To investigate the relationship between blood pressure fluctuation and prethrombotic state in patients with type 2 diabetes mellitus (T2DM). Methods Blood pressure, daytime and nocturnal variability of blood pressure were measured at 24-h in T2DM patients (diabetic group, 121 cases) and healthy volunteers (control group, 119 cases). Plasma von Willebrand factor (vWF), platelet α granule membrane protein 140 (GMP-140), fibrinogen (FG), D-dimer, plasminogen activator inhibitor 1 (PAI-1) and tissue plasminogen activator ). Blood pressure variability and prethrombotic state indicators were compared between the two groups, and the correlation analysis was made. Results The 24 h-systolic pressure, daytime systolic pressure and nighttime systolic pressure variability in diabetic group were significantly higher than those in control group (P <0.05). The levels of vWF, D-dimer and PAI-1 in diabetic group were higher than those in control group ). Systolic pressure variability of 24-h in diabetic group was positively correlated with vWF and GMP-140 (r = 0.713 and 0.624, respectively, P <0.05); 24-h and nocturnal diastolic variability were positively correlated with GMP-140 And 0.634, P <0.05). Conclusion The variability of T2DM patients is significantly increased, accompanied by vascular endothelial damage, activation of platelets and coagulation and fibrinolysis system.