糖尿病患者血小板聚集、释放试验及血小板活化分子标志物测定的临床意义

Detection and clinical significance of blood platelet aggregation test、platelet release reaction and molecule marker of activated platelet in patients with type 2 diabetes mellitus

目的探讨糖尿病患者血小板聚集、释放试验及血小板α-颗粒膜蛋白(GMP-140)的测定及临床意义。方法应用阻抗法与荧光法同步测定血小板聚集及ATP释放反应;应用ELISA法测定血浆中血小板α-颗粒膜蛋白(GMP-140)。结果糖尿病患者血小板聚集功能、ATP释放量及血浆GMP-140含量较正常对照组明显升高,差异有统计学意义(P<0.05或P<0.01);糖尿病有并发症组与无并发症组比较,血小板聚集功能、血浆GMP-140含量差异亦有统计学意义(P<0.05或P<0.01),且病情越重增高越明显;而ATP释放量则无明显差异。糖尿病有并发症组与无并发症组血小板聚集功能及血浆GMP-140含量水平呈直线正相关关系(r2=0.653,P<0.05;r2=0.471,P<0.05)。结论糖尿病患者血小板处于过度活化状态,引起凝血功能亢进,可能是导致糖尿病发病和引起并发症的原因之一。测定血小板聚集试验和血浆中GMP-140含量的水平,及时发现血小板功能状态的改变,对于指导糖尿病的临床诊断及治疗具有重要意义。

Objective To explore the detection and clinical significance of blood platelet aggregation test(PAgT)、platelet release reaction and platelet alpha granule membrane protein(GMP-140) levels in patients with type 2 diabetes mellitus(DM).Methods PAgT and release of platelet ATP were measured simultaneously using a whole-blood Lumi-Aggregometer,and plasma GMP-140 levels were determined by ELISA respectively in 35 health control group and 56 patients with DM(DM group).Results In DM group PAgT and release of platelet ATP and plasma GMP-140 levels were significantly higher than those of control group;In DM with complication group PAgT and GMP-140 were significantly higher than those of DM with non-complication group but platelet ATP release reaction did not.There was a positive correlation between the PAgT and plasma GMP-140 levels in DM with and non complication group(r2=0.653,P <0.05;r2=0.471,P<0.05 respectively).Conclusions There was an abnormal activated platelet in patients with type 2 diabetes mellitus,which may lead the coagulation system presenting an abnormal higher level.It is important for the diagnosis and therapy of DM to observe the changes of the PAgT and plasma GMP-140 levels.