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选择伴高凝血症的IGT、2DM各36例,正常对照(血糖正常不伴高凝血症)36例,分为:正常对照、IGT、2DM组。再将IGT、2DM组随机分治疗组和对照组,治疗组予抗高凝血治疗。各组治疗前后进行全血黏度、血浆凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原、血脂测定及口服葡萄糖耐量试验及胰岛紊释放试验。结果:①2DM组空腹胰岛素、胰岛素抵抗指数明显高于正常对照组,而胰岛B细胞分泌指数、功能指数显著低于正常对照组。②多元逐步回归分析显示,血脂异常、胰岛素抵抗及胰岛B细胞功能指数是影响高凝血症的重要因素。③IGT、2DM组经治疗,高凝状态改善后胰岛紊抵抗指数明显降低;胰岛B细胞分泌指数、功能指数显著增高。结论:高凝状态可随胰岛素抵抗和B细胞功能变化,治疗高凝血症对2DM的胰岛素抵抗及B细胞功能的改善有益。
Thirty-six patients with IGT and 2DM were enrolled in this study. Thirty-six patients with normal control (hyperglycemia without hypercapnia) were divided into two groups: normal control group, IGT group and 2DM group. Then IGT, 2DM group randomly divided into treatment group and control group, the treatment group to anti-hypercoagulable therapy. Whole blood viscosity, plasma prothrombin time, activated partial thromboplastin time, fibrinogen, blood lipids, oral glucose tolerance test and islet release test were performed before and after treatment. Results: ① The fasting insulin and insulin resistance index of 2DM group were significantly higher than those of normal control group, while the secretion index and function index of islet B cell were significantly lower than those of normal control group. ② Multiple stepwise regression analysis showed that dyslipidemia, insulin resistance and islet B cell function index were the important factors affecting hypercapnia. ③IGT, 2DM group after treatment, hypercoagulable state improved insulin resistance index was significantly reduced; islet B cell secretion index, function index was significantly higher. CONCLUSIONS: Hypercoagulable state may be associated with insulin resistance and changes in B cell function, and treatment of hypercapnia may be beneficial in improving insulin resistance and improving B-cell function in patients with 2DM.