Ephraim Richard Kd, Awuku Yaw A, Adu Patrick, Ampomah Lord Tw, Adoba Prince, Panford Solomon, Ninnoni Jerry Pk, Agbodzakey Hope
Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast.
Department of Internal Medicine and Therapeutics, University of Cape Coast, Cape Coast.
Ghana Med J. 2017 Sep;51(3):101-107. doi: 10.4314/gmj.v51i3.2.
Persistent hyperglycaemia in diabetes mellitus causes coagulopathies due to glycation of haemoglobin, prothrombin, fibrinogen and other proteins involved in the clotting mechanism. Shortened activated partial thromboplastin time (APTT) and prothrombin time (PT) reflect hypercoagulable state, which is associated with an increased thrombotic risk and adverse cardiovascular effects. This study assessed the coagulation profile of type 2 diabetes mellitus (T2DM) clients at a municipal hospital in Ghana.
A hospital-based case-control study was conducted from January to April 2015 at the Agona Swedru Municipal Hospital. Sixty (60) persons with T2DM and 40 without were recruited and screened using appropriate protocols. Blood samples were collected for coagulation and biochemical tests. Demographic and clinical information were collected using pre-tested questionnaire. Data was analyzed with GraphPad Prism version 5.
APTT and PT were significantly shorter among patients with T2DM compared to those without (20.88 ± 5.19 v 31.23 ± 5.41, =0.0001; and 11.03 ± 2.06sec v 14.46 ± 1.86, =0.0001 respectively). INR was decreased among patients with T2DM compared to those without (0.83 ± 0.18 v 1.13 ± 0.17, =0.0001). No significant difference was found in platelet count between T2DM and non-diabetics (179.85 ± 66.15×10 /mm v 168.55 ± 35.77×10 /mm, =0.326). Serum magnesium was lower among the T2DM patients compared to the non-diabetics, while serum ionized calcium was significantly higher among the T2DM patients (P<0.05).
Clients with T2DM may have a high coagulation risk evidenced by shortened APTT, PT and a high ionized calcium compared with controls.
Study was funded by Lord Ampomah and Solomon Panford.
糖尿病患者持续高血糖会因血红蛋白、凝血酶原、纤维蛋白原及其他参与凝血机制的蛋白质糖基化而导致凝血功能障碍。活化部分凝血活酶时间（APTT）和凝血酶原时间（PT）缩短反映了高凝状态，这与血栓形成风险增加及心血管不良影响相关。本研究评估了加纳一家市立医院中2型糖尿病（T2DM）患者的凝血情况。
2015年1月至4月在阿戈纳·斯韦德鲁市立医院进行了一项基于医院的病例对照研究。招募并使用适当方案筛查了60例T2DM患者和40例非T2DM患者。采集血样进行凝血和生化检测。使用预先测试的问卷收集人口统计学和临床信息。数据用GraphPad Prism 5版软件进行分析。
与非T2DM患者相比，T2DM患者的APTT和PT显著缩短（分别为20.88±5.19对31.23±5.41，P = 0.0001；以及11.03±2.06秒对14.46±1.86，P = 0.0001）。与非T2DM患者相比，T2DM患者的国际标准化比值（INR）降低（0.83±0.18对1.13±0.17，P = 0.0001）。T2DM患者与非糖尿病患者的血小板计数无显著差异（179.85±66.15×10⁹/mm³对168.55±35.77×10⁹/mm³，P = 0.326）。与非糖尿病患者相比，T2DM患者的血清镁较低，而血清离子钙显著较高（P<0.05）。
与对照组相比，T2DM患者的APTT、PT缩短以及离子钙升高表明其可能具有较高的凝血风险。
本研究由洛德·安波马和所罗门·潘福德资助。
