【摘要】 目的 观察2型糖尿病合并冠心病患者平均血小板体积(MPV)的变化及相关影响因素。方法 接受冠脉造影的2型糖尿病患者495例,其中合并冠心病者307例(合并冠心病组),无冠心病等大血管病变者(未合并冠心病组)188例。入院时测定MPV、血生化等参数,计算冠脉病变血管支数和Gensini积分。结果 合并冠心病组MPV显著高于未合并冠心病组(P<0.05)。据MPV将合并冠心病组患者分为MPV低值组(MPV≤9.9 fL)、中值组(9.9 fL>MPV≤10.6 fL)和高值组(MPV>10.6fL),高值组急性冠脉综合征、多支病变、Gensini积分、体重指数、空腹血糖和糖化血红蛋白(HbAlc)显著高于低值组(P<0.05或P<0.01),高密度脂蛋白胆固醇(HDL-C)显著低于低值组(P<0.05)。多重线性回归分析显示,合并冠心病组患者Gensini积分、多支病变、HbAlc和空腹血糖与MPV显著独立正相关,HDL-C与MPV显著独立负相关。非条件Logistic分析显示,MPV是2型糖尿病合并冠心病的危险因素。结论 2型糖尿病合并冠心病患者MPV显著升高,与冠脉病变严重程度、糖代谢和HDL-C密切相关,MPV是2型糖尿病合并冠心病的危险因素。更多还原

【Abstract】 Objective To investigate the changes of mean platelet volume(MPV) in type 2 diabetes mellitus(DM) patients with coronary artery disease(CAD) and its relating factors.Methods Total495 DM patients underwent coronary angiography were enrolled,including 307 patients with CAD and 188 patients without CAD and other large vessel disease.MPV,fasting plasma glucose(FPG),glyeosylated hemoglobin(HbA1c) and other routine laboratory blood examination were taken on admission.Gensini score and the number of diseased vessels were used to reflect the severity of coronary atherosclerosis.Results MPV in DM patients with CAD was much more increased than in those without CAD(P<0.05).The DM patients with CAD were divided into three groups according to MPV tertiles.There are significantly more acute coronary syndrome and multivessel disease patients,and higher coronary Gensini scores,body mass index,fasting plasma glucose and glycosylated hemoglobin in MPV higher group than in MPV lower group(P<0.05 or P<0.01).Patients with higher MVP have significantly decreased high density lipoprotein cholesterol(HDL-C) levels than in MPV lower group(P <0.05).Multivariate regression analysis revealed that Gensini score,multivessel,HbAI c and FPG were strong and independent positively associated with MPV,however,HDL-C was independent negative predictor of MPV in DM patients with CAD.In multivariate logistic regression analysis,MPV was the variable independently related to the occurrence of CAD in DM patient.Conclusion In DM patients with CAD,MPV was markedly increased and the severity of coronary atheroselerosis,glucose metabolism and HDL-C may be the major determinants of the MPV.MPV was one of the risk factors for the occurrence of CAD in DM patients.更多还原