2型糖尿病患者血小板微粒检测及其临床意义研究

The Detection and Clinical Significance of Platelet Microparticles in Plasma of Type 2 Diabetes

目的血小板微粒是血小板在活化过程中释放的一种超微膜性囊泡,在人体血栓与止血过程中发挥重要作用。由于糖尿病病人容易发展为高凝状态、动脉粥样硬化、冠心病等并发症,采用流式细胞术检测2型糖尿病患者血小板微粒,并同时检测2型糖尿病患者及对照组的尿微量白蛋白、尿转铁蛋白、血糖、血小板、血脂等指标,探讨糖尿病并发症的发病机制,利于2型糖尿病病情的监测和治疗,本研究希望糖尿病患者血小板微粒的检测能成为糖尿病病情发展新的监测指标,从而对于预防、治疗糖尿病并发症的发生有重要意义。方法PMPs检测采用流式细胞术(内参定位法)。结果半年糖尿病患者组和1年糖尿病患者组PMPs水平与正常对照组没有差异,而2年糖尿病患者组、3年糖尿病患者组和3年以上糖尿病患者组PMPs水平与正常对照组比较有非常显著差异,并且随糖尿病患病时间越长PMPs水平升高越明显;PMPs与2型糖尿病患者尿MA和尿TRF检测存在相关性而与血脂、血糖、血小板等指标没有相关性。结论PMPs检测较尿微量白蛋白(MA)、尿转铁蛋白(TRF)检测能更早反映糖尿病患者微血管的病变。本研究结果提示血小板微粒的检测能成为2型糖尿病病情发展新的监测指标。

Objective Platelet Microparticiles(PMPs) are microvesicles released by activated platelets.PMPs may contribute to hemostasis and thrombogenesis.Patients with Type 2 diabetes usually develop many complacations,for example,coronary artery disease and coronary atheroma.Using flow cytometry,we analyzed PMPs from plasma samples of patients with Type 2 diabetes.We hope PMPs may be a new marker that can examine microvascular disease in Type 2 diabetes.Method Venous blood was obtained from 96 Type 2 diabetic patients and 30 non-diabetic control subjects.PMPs,CD61P positivity on platelets,were quantified by flow cytometry.At the same time,MA and TRF from urine samples of the patients were measured.We also detected PLT GLU TCHO TG HDL-C LDL-C LP(a) of the patients.Results PMPs counts were significantly greater in 2 year or up 2 year groups than in controls.PMPs are associated with urine MA and TRF.PMPS have no relationshinp with other markers.Conclusion PMPs may be a marker of microvascular disease in Type 2 diabetes.