Dergiler / Şişli Etfal Hastanesi Tıp Bülteni / 2003 / Cilt: 37 - Sayı: 2
Diabetes mellituslu olgularda koagülasyon ve fibrinolitik aktivite göstergesi olarak antithrombin III ve D-dimer düzeyleri
- Sayfa
- 39–45
- DOI
- —
Özet
Amaç: Bu çalışma diabetes mellituslu olgularda koagülasyon ve fibrinolitik aktiviteyi araştırmak, ayrıca diabetik olgularda glikometabolik kontrol durumu ile koagülasyon aktivitesi ve fibrinoliz arasındaki ilişkiyi saplamak için yapılmıştır. Gereç ve Yöntem: Sağlıklı 20 kontrol olgusunda ve 35 komplikasyonlu diahetik olguda Antitromhin III (ATH III), D-dimer, Fibrin yıkım ürünü (FDP) düzeylerini tayin ettik ve Hemoglobin AIc (HbA1c) ile ATH III ve D-dimer arasındaki korelasyonu araştırdık. Bulgular: Çalışmamızda DM' lu olguların ATH III ve D-Dimer düzeylerini sağlıklı kontrol olgularından anlamlı derecede yüksek bulduk (p 0.5). İyi kontrollü grubun D-dimer düzeyi 0.47±0.27 kötü kontrollü grubun D-dimer düzeyi 0.56$pm$0.40 $mu$g/ml olarak bulduk. Komplikasyonlu diahetik çalışma grubumuzda yaş ile D-dimer arasında hafif derecede bir korelasyon vardı (r=0.4167, p<0.013). Yaş ile ATH III arasında ise korelasyon tespit edilmedi. Sonuçlar: Bu bulgularımıza dayanarak DM' Iu olgularda koagülasyon aktivitesi ve fibrinolizisin arttığı kanısına vardık. Kötü metabolik kontrollü DM'Iu olgularda koagülasyon aktivitesi daha fazla artmaktadır. Glikometabolik kontrolle fibrinolitik aktivite arasındaki ilişki ise HbA1c ile gösterilmemektedir
Abstract
Objective: This study was done in order to investigate coagulation and fihrinolytie activity in patients with diabetes mellitus, in addition to detect the relationship between glycometabolic control and coagulation activity and fibrinolysis in diabetics. Study design: We determined levels of ATH III, D-dimer, and FDP in 20 healthy subjects and 35 diabetic patients with complications and we examined the correlations between HbA1c and ATH III and D-dimer. Results: Compared to the control subjects, we found significantly increased ATH HI and D-dimer levels in patienlts with diabetes mellitus (p<0.0060 and p<0.001, respectively). Clinically relevant increases in FDP levels were observed in diabetics (p<0.050). In patients with good and poor glucose control, we noted significant differences between HbA1c and fasting Mood sugar (p<0.000 and p<0.000, respectively). There was a moderate correlation between HbA1c and ATH III in all diabetics (r=0.49, p<0.03) ; similarly a moderate correlation between HbA1c and ATH III was found in patients with poor glucose control (r=0.47, p<0.048). Parallel to this finding, we detected higher ATH III levels in patients with poor glucose control (%112.83$mu$23 versus %100.71±19). No statistically significant relationship was found between HbA1c and D-dimer levels. D-dimer levels in patients with good and poor glouce control were 0.47$pm$0.27 $mu$g/ml and 0.56±0.40 $mu$g/ml, respectively. In patients with complications of diabetes mellitus, a slight correlation was noted between age and Ddimer levels (r=0.4l67, p<0.013), whereas there was no correlation between age and ATH III. Conclusion: In view of our results, we concluded that coagulation and fihrinolytic activity increased in patients with diabetes mellitus, with even more increases in coagulation activity in those with poor glucose control. The relationship between the glycometabolic control and fihrinolytic activity could not be demonstrated using HbA1c levels.