目的：糖尿病与急性缺血性脑卒中患者临床不良预后密切相关。除此之外，糖尿病还可能影响凝血系统，但其对缺血性脑卒中致病病因——血栓病理组织学的影响尚不清楚。本研究的目的是探究糖尿病对急性缺血性脑卒中患者血栓成分的影响。
方法：回顾性纳入 2017 年 6 月至 2019 年 6 月我院急性缺血性脑卒中成功取栓的患者。血栓的组织学染色包括苏木精和伊红（hematoxylin and eosin, H&E）染色、马休猩红蓝染色（Martius Scarlet Blue, MSB），血管性血友病因子（von Willebrand Factor, vWF）免疫组化染色。根据患者有无糖尿病史或入院时有无高血糖（≥ 7.8 mmol/L）比较血栓成分的差异。
结果：共纳入 52 名急性缺血性脑卒中患者，其中 26 名患者既往诊断为 2 型糖尿病。与非糖尿病患者相比，伴有糖尿病的脑卒中患者入院时血清葡萄糖水平更高（8.90 vs. 7.40，P = 0.012）。糖尿病患者和非糖尿病患者的基线特征（除吸烟史和血栓位置）、手术过
程和临床结局都相似。在血栓组织学方面，与非糖尿病患者相比，糖尿病患者的血栓中纤维蛋白含量较高（44.2% vs. 28.3%， P = 0.004），红细胞含量较低（26.0% vs. 42.9%，P = 0.013），血小板含量（24.0% vs. 21.5%， P = 0.694） 及 vWF（0.041 vs. 0.031， P = 0.234）在两类患者血栓中未见明显差异。根据急性缺血性脑卒中患者有无入院高血糖分析后发现，两组患者红细胞（41.6% vs. 27.3%， P = 0.105）、纤维蛋白（37.6% vs. 34.3%， P = 0.627）、血小板（21.2% vs. 24.2%， P = 0.498）和 vWF 因子（0.038 vs. 0.034，P = 0.284）的含量未见明显统计学差异。
结论：与不伴糖尿病的脑卒中患者相比，伴有糖尿病的患者血栓中纤维蛋白含量更多而红细胞含量较少；有无入院高血糖与血栓成分相关性不大。

Objective: Diabetes mellitus (DM) indicated poor clinical prognosis for patients with acute ischemic stroke (AIS). Moreover, it is also unclear whether DM affects the hemostatic system as well as the histological composition of thrombi.
Methods: The study included consecutive patients who had retrieved clots. Histologic staining for thrombus included Martius Scarlet Blue, hematoxylin and eosin, immunohistochemistry for von Willebrand factor. Diabetes mellitus history or admission hyperglycemia (≥ 7.8 mmol/L)
were compared with the differences in clot composition.
Results: In total, 52 patients were examined; half of them had previously been diagnosed with diabetes mellitus. Diabetic patients showed higher serum glucose on admission (8.90 vs. 7.40, P = 0.012). The baseline characteristics (expect thrombus location and smoking history), procedural, in diabetic and non-diabetic patients, clinical outcomes were similar. As for histologic composition, thrombus in patients with diagnosed diabetes mellitus had fewer red blood cells (26.0% vs. 42.9%, P = 0.013), more fibrin (44.2% vs. 28.3%, P = 0.004),
equivalent content of platelets (24.0% vs. 21.5%, P = 0.694) and von Willebrand factor (0.041 vs. 0.031, P = 0.234) than nonDM patients. However, there was no statistical difference in the content of fibrin (37.6% vs. 34.3%, P = 0.627), red blood cells (41.6% vs. 27.3%, P = 0.105), platelets (21.2% vs. 24.2%, P = 0.498), and von Willebrand factor (0.038 vs. 0.034, P = 0.284)
between patients with or without hyperglycemia on admission.
Conclusion: There were more fibrin and fewer RBCs components in diabetic clots than in patients without DM, while hyperglycemia on admission did not influence clot composition. More research is needed to confirm these findings.