2型糖尿病患者纤溶系统的变化与大血管病变的相关性研究

Changes of Fibrinolysis and Its Relationship with Type 2 Diabetic Macro-vascular Complication

目的探讨2型糖尿病患者的纤溶功能,以及它们在大血管病变中的作用,分析其纤溶功能紊乱的可能原因。方法选取2型糖尿病患者66例,根据是否合并大血管病变分为两个亚组(Non-MVC,非大血管病变组40例;MVC组,大血管病变组26例);另设正常对照组32例,采用酶联免疫吸附法(FLISA)测定血浆纤溶酶-α2抗纤溶酶复合物(PAP)、组织型纤溶酶原激活剂(t-PA)、纤溶酶原激活剂抑制物(PAI-1)水平,同时测定其它一些临床生化指标。结果与正常对照组相比,2型糖尿病患者各组血浆t-PA、PAI-1和PAP水平显著升高;MVC组PAI-1水平较非大血管病变组显著升高;相关分析显示,血浆t-PA、PAI-1和PAP水平与体重指数(BMI)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)等指标显著相关。结论2型糖尿病患者在存在纤溶活性的降低,并可能由此影响了糖尿病血管病变的发展。

Objective To investigate the changes of fibrinolysis and its effect on type 2 diabetic angiopathies and analyze the possible causes of abnormal of fibrinolysis. Methods 66 patients with T2DM（ 1999 WHO diagnostic standards）were selected for this study, They were divided into two groups based on the presence or absence of diabetic macro -vascular complications （MVC） ;The control group was composed of 32 healthy volunteers. Serum plasmin -α2 -antiplasmin,tissue plasminogen activator and plasminogen activator inhibitor - 1 were measured by enzyme linked immunosorbent assay（ELISA） , and some others clinical and biochemical dates were also measured. Results Compared with normal controls, the serum levels of PAP, t - PA and PAI- 1 were significantly increased （P 〈 0.01,P 〈0.05,P 〈0.01）;Compared with non-MVC group, the serum levels of PAI-1 were increased（ P 〈 0. 01 ） in MVC group;By bivariate correlation analysis between BMI,FPG,HOMA - IR,HbAIC,FIB,lipids and PAP,PAI - 1 or t - PA,the serum of t - PA,PAI - 1 and PAP had a re- markably positive correlation with BMI,FPG and HOMA - IR. Conclusion The fibrinolysis of type 2 diabetic patients is impaired, this might be one of the reasons that accelerate the development of diabetic vascular complication.