The Significance Of Detection Of Thrombelastography In Patients With Type 2 Diabetes Mellitus Complicated With Cerebral Infarction

Objective: To investigate the characteristics of thrombelastography(TEG)in patients with type 2 diabetes mellitus complicated with cerebral infarction,and to clarify the necessity of clinical examination of TEG;To analyze the risk factors of cerebral infarction developed by T2DM.Method: A total of 80 patients with T2DM were selected from Department of endocrinology in our hospital from January 2016 to December 2016;According to whether complicated with cerebral infarction,T2DM patients were divided into T2DM group(n=35)and T2DM complicated with cerebral infarction group(n=45);Detailed records of all basic information of the participants(including age,sex,smoking history,etc.)and related medical history.Testing fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),low-density lipoprotein cholesterol(LDL-C),platelet(PLT).The parameters of the TEG including reaction time(R),kinetics time(K),Angle and maximum amplitude(MA)was detected by the related instruments.Determination of coagulation parameters of prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)by the ELITE PRO full automatic blood coagulation analyzer.All these data were analyzed by SPSS19.0 software.The differences of TEG parameters,HbA1 c and routine coagulation parameters between the two groups were compared and analyzed.P<0.05 was considered as statistically difference.Result:1.T2DM complicated with cerebral infarction group and T2DM group TEG parameters: R value,K value were shortened,Angle angle,MA value were prolonged,there was statistical significance.(P < 0.05)2.T2DM complicated with cerebral infarction group compared with T2DM group: gender,smoking history,FPG,PLT and LDL-C had no statistical significance(P > 0.05);there was statistical significance in age,history of hypertension(P < 0.05);HbA1c,FIB value was increased with statistical significance.(P < 0.05);PT value,APTT value had no statistical significance(P > 0.05)3.Multivariate Logistic analysis showed that age,hypertension,and HbA1 c were the risk factors for the development of T2DM.4.TEG parameter R value was positively correlated with APTT,K value was negatively correlated with FIB,Angle was positively correlated with APTT and FIB,MA was positively correlated with FIB and PLT.Conclusion:There were significant differences in TEG parameters and FIB between T2DM group and T2DM group,and have statistical significance,indicating that T2DM complicated with cerebral infarction patients with hypercoagulable state is more obvious;There was significant difference in age,hypertension and HbA1 c between T2DM group and T2DM group,the Logistic regression analysis was performed that hypertension and HbA1 c are independent risk factors for the development of T2DM in cerebral infarction,the reason maybe related to the aggravation of vascular injury and the promotion of atherosclerosis(AS);The correlation analysis between TEG parameters and routine coagulation tests showed that they were closely related,and routine coagulation can assist TEG to some extent,therefore,we hypothesized that T2DM patients with a joint examination,may be able to detect early coagulation abnormalities,and also can more accurately evaluate the causes of cerebral infarction coagulation abnormalities.Whether TEG combined with routine coagulation can predict the occurrence of cerebral infarction and correlation between TEG parameters and severity of cerebral infarction in T2DM needs further study...