血浆纤溶酶原激活物抑制物-1与不同糖化血红蛋白水平2型糖尿病患者大血管病变的关系

Relationship between the Levels of Plasminogen Activator Inhibitor-1 and the Type 2 Diabetes Mellitus Macro-vascular Complication in Patients with Different HBA1c Levels

目的:探讨不同糖化血红蛋白(HBA1c)水平的2型糖尿病患者血浆纤溶酶原激活物抑制物-1(PAI-1)与糖尿病大血管病变的关系。方法:246例2型糖尿病患者,按不同HBA1c水平及有无大血管并发症分为4组,采用酶联免疫吸附法测定其PAI-1的水平。选49例健康体检者为正常对照组。结果:有大血管病变组的PAI-1水平比无大血管病变组及对照组均升高(P<0.01);多元逐步回归分析显示糖尿病有大血管病变组的PAI-1与年龄、游离脂肪酸(FFA)、体重指数(BMI)和腰臂比(WHR)相关;在有大血管病变组或无大血管病变组中,不同HBA1c水平组间PAI-1水平无显著差异(P≥0.05);相同HBA1c水平病例组间,糖尿病大血管病变患病率无显著差异(P≥0.05)。结论:PAI-1水平升高与糖尿病大血管病变有关。单纯血糖控制达标,不能有效降低PAI-1水平,对糖尿病患者进行多个代谢因素同时控制可能更有利于预防大血管病变的出现。

Objective：To investigate the relationship between the plasma level of plasminogen activator inhibitor-1（PAI-1） and the type 2 diabetes mellitus with macro-vascular complication patients with different HBA1c levels.Methods：The plasma concentrations of PAI-1 were determined by ELISA in 49 healthy controls（Control group） and 246 diabetic patients,which were further subdivided into 4 subgroups,based on HBA1c levels and with or without macro-vascular complication.Results：The PAI-1 levels of macro-vascular patients were higher than patients without macro-vascular and the control group（P〈0.01）;Multivariant stepwise regression analysis revealed that there was linear regession relationship between PAI-1 and age,free fatly acid（FFA）,body mass indes（BMI） and waist-hipratio（WHR） in the diabetes mellitus with macro-vascular complication;The patients with different HBA1c levels had the levels of PAI-1 in with or without macro-vascular groups（P≥0.05）;The morbidity of the type 2 diabetes mellitus macro-vascular complication was no difference in with or without macro-vascular groups（P≥0.05）.Conclusion：The plasma levels of PAI-1 might be correlated to the type 2 diabetes mellitus macro-vascular complication.The treatment of the type 2 diabetes mellitus might be not only a good control of blood glucose,witch could not decrease the plasma levels of PAI-1 effectively,but also the intensive control for much more metabolic factors to prevent the epidemic of macro-vascular complication.