| Objective:To retrospectively analyze the blood routine,coagulation function,blood lipids,blood sugar,thyroid function and other related indicators of type 2 diabetic patients with venous thrombosis of lower extremities,so as to evaluate the risk of thyroid hormone on the formation of venous thrombosis in type 2 diabetic patients,and provide a theoretical basis for preventing the occurrence of venous thrombosis in patients with type 2 diabetes.Method:1.from December 2020 to November 2021,111 patients with type 2 diabetes were admitted to Affiliated Hospital of Chuanbei Medical College.They were divided into 2 groups according to whether they had venous thrombosis or not.They were divided into 2 groups:2 patients with lower limb venous thrombosis(40 cases)and 2 patients with non deep venous thrombosis(71 cases).2.Collect the general data of all cases,including age,gender,course of disease,smoking history,drinking history,blood routine,coagulation function,D-dimer,thyroid related indexes including serum thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroid hormone(FT4),blood glucose related indexes including fasting blood glucose(FBG)Glycosylated hemoglobin concentration(HbA1c)and blood lipid related indexes include total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C)and vascular ultrasound of both lower limbs.3.Compare the differences of general data(age,gender,course of disease,smoking history,drinking history),thyroid function,blood routine,coagulation function,blood glucose,blood lipid and other related indicators between the two groups,and further analyze the influencing factors of lower extremity venous thrombosis in patients with type 2 diabetes mellitus.4.SPSS 26.0 statistical software was used for data analysis.The enumeration data were tested by χ2 test.Two-sample independent t-test was used for the measurement data that conformed to the normal distribution.The results were expressed as x±S.After the non-normal distribution data were transformed into normal distribution by logarithm,two-sample independent t-test was used.The results were expressed as x±S.The measurement data that could not be transformed into normal distribution were analyzed by Mann-Whitney test.The results were expressed as M(P25,P75).The indicators with statistical significance were used for logistics single factor regression analysis.After determining the influencing factors related to thrombosis,logistics multi-factor regression analysis was conducted.The ROC curves of FT3,FT4 and the risk of lower extremity venous thrombosis were plotted respectively,and the area under the curve(AUC)was compared.The Yordon index was calculated according to the ROC curve.P<0.05 indicated that the difference was statistically significant.Result:1.The mean age,female proportion and smoking history of type 2 diabetic lower limb venous thrombosis group were higher than those of non-lower limb venous thrombosis group,and the difference was statistically significant(P<0.05).The course of disease and drinking history of the two groups were not statistically significant P>0.05).2.The mean level of hemoglobin(Hb)in type 2 diabetic lower limb venous thrombosis group was lower than that in non venous thrombosis group(P<0.05).The average level of D-2 polymer in thrombosis group was significantly higher than that in non lower extremity venous thrombosis group(P<0.05).3.There was no significant difference in WBC,PLT,APTT,Pt,FIB,INR,TC,TG,HDL-C,LDL-C,FBG and HbA1c between the two groups(P>0.05).4.The mean level of serum free three iodine FT3 and free thyroxine(FT4)in type 2 diabetic patients with lower limb venous thrombosis was significantly lower than that in type 2 diabetic patients with non deep venous thrombosis(P<0.05).There was no significant difference in serum thyrotropin(TSH)between the two groups(P>0.05).5.According to the results of multiple regression analysis,age(r=1.92,P<0.05),gender(r=4.049,P<0.05),smoking history(r=4.596,P<0.05),Hb(r=0.966,P<0.05),D-dimer(r=1.536,P<0.05),FT3(r=0.366,P<0.05)and FT4(r=0.065,P<0.05)were correlated with the occurrence of lower limb venous thrombosis in type 2 diabetes mellitus,and were risk factors of lower limb venous thrombosis in type 2 diabetes mellitus.That is,older,smoking history,female,lower Hb,higher D-dimer,lower FT3,and lower FT4 patients with type 2 diabetes may be more prone to thrombosis.Age and D-dimer are independent risk factors for lower limb venous thrombosis in patients with type 2 diabetes,that is,the older the age and the higher the D-dimer the patients with type 2 diabetes are more likely to develop thrombosis.6.According to the ROC curve results,the critical values of FT3 and FT4 for lower limb venous thrombosis were 2.39pmol/L and 1.14ng/dL respectively,that is,if serum FT3 and FT4 were lower than the above values,the risk of thrombosis would be greater in type 2 diabetes patients.Conclusion:1.According to the statistical results of this study,compared with the type 2 diabetes group without lower limb venous thrombosis,serum FT3 and FT4 in the thrombosis group were decreased,with statistically significant differences,and FT3 and FT4 were risk factors for type 2 diabetes patients.It can roughly predict the risk of lower limb venous thrombosis in patients with type 2 diabetes when serum FT3 and FT3 are lower than 2.39pmol/L and 1.14ng/dL,respectively.2.This study shows that older female patients with type 2 diabetes and smoking history are more likely to develop thrombosis.Therefore,elderly and female patients with type 2 diabetes should quit smoking and have regular detection of lower limb angiography.3.The number of cases included in this study is small and not universal,so there may be some deviations in the study results,which need to be confirmed by further studies.4.Thyroid function of healthy people and thyroid function of type 2 diabetes were not included in this study as the control group,so it cannot be ruled out whether type 2 diabetes is a factor affecting thyroid function,which may cause mixed interference to explore the influence of thyroid hormone and type 2 diabetes complicated with lower limb venous thrombosis.5.Due to the lack of some clinical biochemical data,thyroid related antibodies such as TPOAb,TGAb and TRAb cannot be collected,and it is impossible to rule out whether thyroid related antibodies will affect thrombosis.Therefore,there are some limitations in the research. |
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