Objective:To investigate the relationship between normal plasma fibrinogen(FIB)levels and disease duration in elderly patients with type 2 diabetes mellitus(T2DM).Methods:Clinical data and biochemical test results of 1 116 elderly subjects with T2DM admitted to the Department of Endocrinology of Shanghai Tianyou Hospital from January 2016 to October 2019 were retrospectively collected and analyzed.Subjects were classified into four groups based on the duration of DM: the Q1 group(n=276, < 2.0 years), the Q2 group(n=278, 2.0-7.9 years), the Q3 group(n=280, 8.0-13.9 years)and the Q4 group(n=282, ≥ 14.0 years). The correlation between FIB and the duration of DM was analyzed.Results:With the prolongation of DM duration, FIB levels increased significantly( P<0.05). Pearson correlation analysis showed that the duration of DM was positively correlated with FIB, age and serum creatinine( P<0.01). Multiple stepwise regression analysis showed that the duration of DM was an independent factor for FIB( β=0.104, P<0.01). Logistic multiple regression analysis showed that after adjusting for sex, age, body mass index, systolic pressure, diastolic pressure, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, serum creatinine, alanine aminotransferase, fasting plasma glucose, glycosylated hemoglobin, smoking and drinking, the risk of hyperfibrinogenemia was 2.436 and 2.104 times higher, respectively, in Group Q4 and Group Q3 than in Group Q1(95% CI: 1.317-4.507, P<0.01; 95% CI: 1.144-3.871, P<0.05). With the third-quartile FIB(3.70 g/L)as the cut-off value, the optimal cut-off point of the DM course was 9.5 years as calculated by receiver operating characteristic(ROC)curve analysis of DM duration and hyperfibrinogenemia. Conclusions:The FIB level is positively correlated with DM duration in elderly patients with T2DM.

目的 探讨老年人群血小板参数与其血压水平的相关性.方法 收集2016年1月至2019年8月于同济大学附属天佑医院门诊及体检的1023例老年人的临床资料.根据血压水平将其分为3组:正常血压组(<120/80 mmHg,215例)、高血压前期组[(120～139/80～89)mmHg,531例]、高血压组(≥140/90 mmHg,277例),分析血小板参数与血压的相关性.结果 高血压组和高血压前期组的血小板平均体积(MPV)和血小板分布宽度(PDW)均高于正常血压组(P<0.05),而各组间PLT和血小板压积(PCT)的差异均无统计学意义(P>0.05).Spearman相关分析显示,MPV和PDW与SBP均呈显著正相关(P<0.01),而PLT和PCT均与SBP无相关性(P>0.05),MPV、PDW、PLT和PCT均与DBP无相关性(P>0.05).多元线性回归分析显示,MPV是SBP的独立影响因素(β=0.110,P<0.01).按照MPV四分位法将研究对象由低到高分为Q1～Q4组,多元Logistic回归分析显示,在校正性别、年龄、身高、体质量、BMI、腰围、臀围、腰臀比、TC、TG、LDL-C、血肌酐、ALT、FPG、吸烟、饮酒因素后,Q4组发生高血压的危险性是Q1组的1.529倍(95％CI:1.106～2.319,P<0.05).结论 老年人群血小板参数与其血压水平密切相关,其中MPV升高可能与高血压的发生及发展有关.