血小板分布宽度及纤维蛋白原与DR严重程度的关系

摘要

目的：明确血小板分布宽度( platelet distribution width, PDW)及纤维蛋白原( fibrinogen,FIB)与糖尿病视网膜病变( diabetic retinopathy,DR)严重程度之间的关系。　　方法：选取2012-06/2014-05在我院眼科及内分泌科住院的DR患者99例(非增殖期48例,增殖期51例),同时选取50例无DR糖尿病患者和50例无糖尿病健康人进行对照。采集基本资料,抽空腹血行PDW、FIB、血小板计数、空腹血糖及糖化血红蛋白(HbA1c)等检查。　　结果：糖尿病各组人群 PDW 水平显著高于健康对照组(16.6%±1.2%)(P<0.05),且随DR病变分级的增加, PDW 水平显著增加,分别为17.6%±1.8%,19.1%±2.1%,20%±1.9%,差异有统计学意义(均为P<0.05)。糖尿病各组FIB水平也显著高于健康对照组( P<0.05)。多因素Logistic回归分析显示,在校正年龄、性别、病程及糖化血红蛋白等因素后,随着PDW及FIB水平升高,非增殖期(OR：1.464,PDW)(OR：2.199,FIB)和增殖期DR (OR：1.652,PDW)(OR：2.691,FIB)的患病风险显著增加(均为P<0.05)。　　结论：PDW和FIB水平随DR严重程度升高而增加,非增殖期和增殖期DR患病风险随PDW及FIB水平升高而增加。%AIM: To define the relationship between platelet distribution width ( PDW) , fibrinogen ( FIB) and severity of diabetic retinopathy ( DR) . METHODS: The survey included 99 patients with DR (48 with non-proliferative and 51 with proliferative DR) in our hospital during June 2012 and May 2014. Another 50 diabetic patients without DR and 50 healthy volunteers were matched as controls. Demographic data and disease history were gained. Fasting blood sample were collected to measure PDW, FIB, platelet count, fasting blood glucose and HbA1c. RESULTS: Compared with healthy controls ( 16. 6%±1.2%) , a significant difference was found in PDW values among diabetic patients ( all P < 0. 05 ). The higher development of DR corresponded with a significantly higher level of PDW 17. 6%±1. 8%, 19. 1%±2. 1%, and 20%±1. 9% for patients without DR, non-proliferative DR and proliferative DR, respectively, the difference had statistical significance (P<0. 05). A significant difference was also found in FIB values among diabetic patients and healthy controls (P<0. 05). After correction for age, gender, disease duration and HbA1c, multi factor Logistic analysis showed that there were significant increased risks in the prevalence of non-proliferative ( OR: 1. 464, PDW) ( OR: 2. 199, FIB) and proliferative DR ( OR: 1. 652, PDW ) ( OR: 2. 691, FIB ) with the increased PDW and FIB value (all P<0. 05). CONCLUSION: The PDW and FIB value are parallel with the severity of DR, and there is increased risk of non-proliferative and proliferative DR with the PDW and FIB value increases.