Koert M, Nowak-Göttl U, Kreuz W, Grüttner H P, Kornhuber B, Breddin H K
Zentrum der Kinderheilkunde, J. W. Goethe-Universität Frankfurt/Main.
Klin Padiatr. 1991 Nov-Dec;203(6):429-32. doi: 10.1055/s-2007-1025468.
15 parameters of coagulation and fibrinolysis were investigated in 38 children with type I diabetes mellitus without clinical signs of diabetic angiopathy. Compared to an age matched non diabetic control group spontaneous platelet aggregation was enhanced, plasma levels for factor VIII C, von Willebrand factor, antithrombin III and C-1-inactivator were elevated, alpha-2-macroglobulin was decreased at onset of the disease. During remission (3, 6, 12 months) these changes reverted to normal. Alpha-2-antiplasmin decreased after 12 months. If, during partial remission, diabetic duration was longer than one year an increase of factor VIII C was seen again. In comparison to the controls no significant alterations were found for ristocetin cofactor, fibrinogen, plasminogen and alpha-1-antichymotrypsin. It seems likely that changes in plasmatic coagulation, fibrinolysis and platelet function during the onset period of diabetes mellitus type I are due to metabolic changes and precede diabetic angiopathy.
对38名无糖尿病血管病变临床症状的Ⅰ型糖尿病患儿的15项凝血和纤溶参数进行了研究。与年龄匹配的非糖尿病对照组相比,疾病发作时自发性血小板聚集增强,凝血因子Ⅷ C、血管性血友病因子、抗凝血酶Ⅲ和C1酯酶抑制物的血浆水平升高,α2巨球蛋白降低。在缓解期(3、6、12个月),这些变化恢复正常。12个月后α2抗纤溶酶降低。如果在部分缓解期糖尿病病程超过1年,则凝血因子Ⅷ C会再次升高。与对照组相比,瑞斯托霉素辅因子、纤维蛋白原、纤溶酶原和α1抗糜蛋白酶无明显变化。Ⅰ型糖尿病发病期血浆凝血、纤溶和血小板功能的变化似乎是由于代谢改变引起的,且早于糖尿病血管病变。