KHARKIV NATIONAL MEDICAL UNIVERSITY, KHARKIV, UKRAINE.
Wiad Lek. 2022;75(2):339-343.
The aim: Aim of study is to assess the influence of urgent reperfusion strategy on the levels of vWf, PAI-1 and sCD40L in patients with acute myocardial infarction (AMI) and concomitant diabetes mellitus type 2 (DM2).
Materials and methods: 255 patients with acute myocardial infarction took part in the study, they were divided into four groups depending on the presence of concomitant diabetes mellitus type 2 and performed treatment: I group - 83 diabetic patients who were underwent urgent reperfusion therapy; II group - 60 diabetic patients who received standard anticoagulant therapy; III group - 65 non-diabetic patients who were underwent urgent reperfusion therapy; IV group - 47 non-diabetic patients who received standard anticoagulant therapy. The levels of von Willebrand factor, PAI-1 and sCD40L were determined by enzyme-linked immunosorbent assay. Statistical data were processed using the Mann-Whitney U-test, the Kruskal-Wallis H-test, quantitative variables were described by the following parameters: median (Me), 25th and 75th percentiles (Q1; Q3).
Results: According to obtained data, we can conclude that patients with acute myocardial infarction and concomitant type 2 diabetes mellitus have higher levels of von Willebrand factor, PAI-1 and sCD40L compared to non-diabetic patients with AMI, which leads to the increasing of the platelets adhesion and aggregation and decreasing of fibrinolysis.
Conclusions: Urgent restoration of blood supply in occluded artery contributed to a statistically significant reduction in levels of von Willebrand factor, PAI-1 and sCD40L levels in both diabetics and non-diabetic patients, reducing the risk of thromboembolic complications and thus improving the prognosis.
研究目的是评估急性心肌梗死（AMI）合并 2 型糖尿病（DM2）患者中紧急再灌注策略对 vWf、PAI-1 和 sCD40L 水平的影响。
共有 255 例 AMI 患者参与本研究，根据是否合并 2 型糖尿病分为四组，分别接受以下治疗：I 组-83 例接受紧急再灌注治疗的糖尿病患者；II 组-60 例接受标准抗凝治疗的糖尿病患者；III 组-65 例接受紧急再灌注治疗的非糖尿病患者；IV 组-47 例接受标准抗凝治疗的非糖尿病患者。采用酶联免疫吸附试验测定 vWf、PAI-1 和 sCD40L 水平。采用 Mann-Whitney U 检验、Kruskal-Wallis H 检验对统计数据进行处理，定量变量采用中位数（Me）、25 分位数（Q1）和 75 分位数（Q3）表示。
根据所得数据，我们可以得出结论，与非糖尿病 AMI 患者相比，急性心肌梗死合并 2 型糖尿病患者的 vWf、PAI-1 和 sCD40L 水平更高，导致血小板黏附和聚集增加，纤溶降低。
闭塞动脉的紧急血运重建有助于显著降低糖尿病和非糖尿病患者的 vWf、PAI-1 和 sCD40L 水平，降低血栓栓塞并发症的风险，从而改善预后。
