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目的:探讨血小板参数与2型糖尿病微血管和外周血管病变的关系。方法:收集650例2型糖尿病患者,检测血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、生化资料、尿微量白蛋白(MAU)以及踝肱比值(ABI)等指标。按MAU值分为MAU组和正常组,按ABI值分为外周血管病变组(PAD组)和非PAD组,分别进行两组间血小板参数和临床资料的比较,并进行影响因素分析。结果:MAU组收缩压(SBP)、总胆固醇(TC)、甘油三酯(TG)、MPV和PDW明显高于正常组(P<0.05),而高密度脂蛋白胆固醇(HDL-C)显著低于正常组(P<0.05)。PAD组腰臀比(WHR)、SBP和TC较正常组升高,HDL-C水平显著降低(P<0.05),而血小板相关参数均未见统计学差异。Logistic多元回归分析结果显示SBP、TC、TG和PDW为影响微量白蛋白尿发生的危险因素(回归系数B>0,P<0.05)。SBP、WHR及HDL-C为影响外周血管病变的独立影响因素(P<0.05)。结论:动态监测血小板参数的变化,尤其是MPV和PDW,有助于早期预测糖尿病患者微血管病变的发生。
Objective: To investigate the relationship between platelet parameters and type 2 diabetes mellitus and peripheral vascular disease. Methods: 650 patients with type 2 diabetes mellitus were enrolled in this study. PLT, MPV, PDW, biochemical data, urine microalbumin (MAU) and ankle-brachial ratio (ABI) . The patients were divided into MAU group and normal group according to the MAU value. According to the ABI value, the patients were divided into PAD group and non-PAD group. The platelet parameters and clinical data were compared between the two groups, and the influencing factors were analyzed. Results: SBP, TC, TG, MPV and PDW in MAU group were significantly higher than those in normal group (P <0.05), while HDL-C was significantly lower In the normal group (P <0.05). The waist-hip ratio (WHR), SBP and TC in PAD group were higher than those in normal group, and HDL-C level was significantly lower (P <0.05), but no correlation was found between platelet-related parameters. Logistic multiple regression analysis showed that SBP, TC, TG and PDW were the risk factors influencing the occurrence of microalbuminuria (regression coefficient B> 0, P <0.05). SBP, WHR and HDL-C were independent influencing factors of peripheral vascular disease (P <0.05). CONCLUSIONS: Dynamic monitoring of platelet parameters, especially MPV and PDW, is helpful for the early prediction of the occurrence of microvascular disease in diabetic patients.