三种微颗粒水平在糖尿病血管病变中的意义

Significance of three kinds of microparticle levels in diabetic angiopathy

目的 分析糖尿病患者微颗粒（包括血小板微颗粒、内皮细胞微颗粒以及组织因子阳性微颗粒）水平,探讨微颗粒水平与糖尿病并发症的相关性.方法 流式细胞仪检测106例糖尿病患者和50例健康志愿者血浆中血小板微颗粒、内皮细胞微颗粒和组织因子阳性微颗粒水平,并比较糖尿病血管病变各组间微颗粒的变化.结果 糖尿病组血小板微颗粒和组织因子阳性微颗粒水平与对照组比较无明显差异（23.09±15.66对38.55±28.56,83.82±82.61对89.06±82.75,均P〉0.05）,而内皮细胞微颗粒水平在糖尿病组明显高于对照组（164.20±128.88对63.81±40.84,P〈0.05）,合并有血管病变者其内皮细胞微颗粒水平又高于单纯糖尿病组（184.12±152.77、188.21±149.55对138.53±99.87,P〈0.05）.结论 内皮细胞功能异常是糖尿病患者,尤其合并有血管病变患者内皮细胞微颗粒升高的原因;内皮细胞微颗粒水平可以用来评价糖尿病患者血管内皮细胞的功能状态和疾病的进展的指标之一.

Objective To investigate the levels of mieropartieles originated from platelet （PMP）,endothelium （EMP）,and tissue factor-bearing microparticles （TF＋ MP） in diabetes mellitus and to analyze its relationship with diabetic angiopathy.Methods PMP,EMP or TF＋ MP were measured in 106 cases of diabetes mellitus and 50 controls by flow eytometry.The differences of EMP between groups of diabetic macrovascular disease and diabetic microvascular disease were determined.Results The levels of EMP in diabetic patients were higher than that in the control（164.20±128.88 vs 63.81±40.84,P〈0.05）.Diabetic cases with complication showed higher expression level of EMP than those without complications（184.12±152.77,188.21±149.55 vs 138.53±99.87,both P〈0.05）.However,no distinct increase was observed in PMP and TF＋ MP level in diabetes groups compared with control group.Conclusions Endothelial dysfunction,may contribute to the increased level of EMP in patients with diabetes,especially those complicated with vascular diseases.EMP level may be used to evaluate the status of endothelial function and the development of diabetic angiopathy.