Grignani G, Gamba G, Biancardi M, De Marco R, Grassi M, Ferrari E
Acta Diabetol Lat. 1982 Jan-Mar;19(1):29-35. doi: 10.1007/BF02581183.
We studied 115 patients with uncomplicated maturity-onset diabetes mellitus, 55 males and 60 females; patients were divided into 7 groups according to the hypoglycemic therapy (diet alone, tolbutamide, glibenclamide, phenformin, combination of the last two drugs, insulin, combination of insulin and phenformin). All patients were tested for a prethrombotic state by the simultaneous determination of the following parameters: ADP-induced platelet aggregation, Factor VIII as antigen and procoagulant activity and the plasma levels of fibrinogen and antithrobin III. Our results show that these parameters were markedly altered in diabetic patients when compared to apparently normal subjects of the same age; on the contrary, differences between groups of diabetic patients were very slight and hardly ever statistically significant. These results suggest that the prethrombotic alterations of hemostatic system are very similar in all groups of diabetic patients; this is true also for patients submitted to diet alone, i.e. with slight and usually recent-onset diabetes mellitus. In conclusion, our study suggests the opportunity, at least from the theoretical point of view, of systematic antiaggregant and/or anticoagulant treatment(s) in maturity-onset diabetes mellitus, whose severe and precocious prethrombotic alterations seem to be independent of the hypoglycemic treatment applied.
我们研究了115例无并发症的成年型糖尿病患者，其中男性55例，女性60例；根据降糖治疗方法（单纯饮食、甲苯磺丁脲、格列本脲、苯乙双胍、后两种药物联合、胰岛素、胰岛素与苯乙双胍联合）将患者分为7组。通过同时测定以下参数对所有患者进行血栓前状态检测：ADP诱导的血小板聚集、因子VIII抗原和促凝活性以及纤维蛋白原和抗凝血酶III的血浆水平。我们的结果表明，与年龄相仿的明显正常受试者相比，糖尿病患者的这些参数有显著改变；相反，糖尿病患者组之间的差异非常微小，几乎没有统计学意义。这些结果表明，所有糖尿病患者组的止血系统血栓前改变非常相似；对于仅接受饮食治疗的患者也是如此，即患有轻度且通常为近期发病的糖尿病。总之，我们的研究表明，至少从理论角度来看，成年型糖尿病患者有必要进行系统性抗聚集和/或抗凝治疗，其严重且早熟的血栓前改变似乎与所应用的降糖治疗无关。
