2型糖尿病患者检查血小板-白细胞聚集体的临床意义

Applicable value of detection for platelet-leukocyte aggregates in patient with type 2 diabetic mellitus

目的研究2型糖尿病(T2DM)患者外周血血小板-白细胞聚集体(PLA)与血小板活化标志CD62p的变化,分析诊断微血管病变的敏感性与特异性,为T2DM患者的诊断、治疗及并发症防治提供实验依据。方法用流式细胞术(FCM)检测T2DM患者外周血血小板CD62p、血小板-粒细胞聚集体(PNA)、血小板-淋巴细胞聚集体(PLyA)和血小板-单核细胞聚集体(PMA)的表达百分率。结果 T2DM组CD62p、PNA、PLyA及PMA的表达率(%)分别为13.38±8.56、16.44±7.71、13.57±7.30、20.07±9.17,均显著高于健康对照组(P均<0.05);T2DM组中有微血管病变组明显高于无微血管病变组(P均<0.05);其中CD62p的敏感性为93.5%,特异性为90.9%;PNA为60.9%和54.5%;P lyA为65.2%和54.5%;PMA为78.3%和68.2%。结论 PNA、PLA、PMA、CD62p均可作为反映T2DM患者微血管病变的临床指标,其中CD62p和PMA较为灵敏和特异,CD62p是首选指标。

Objective To observe the variation of CD62p,the marker of platelet activation and platelet-leukocyte aggregates（PLA） in type 2 diabetes mellitus（T2DM） patients,analyze their sensitivity and specificity,and provide laboratory evidences for clinical diagnosis and treatment as well as prevention of complications for diabetes.Methods The percentage of platelet CD62p and the expressions of platelet-neutrophil aggregates（PNA）,platelet-lymphocyte aggregates（PlyA） and platelet-monocyte aggregates（PMA） in the patients with T2DM were determined by flow cytometry（FCM）.Results he percentage of CD62p,PNA,PLA,PMA in T2DM were significantly higher than that in healthy controls [（13.38±8.56）% vs（3.41±1.09）%,（16.44±7.71）% vs（7.99±4.58）%,（13.57±7.30）% vs（8.29±5.57）%,（20.07±9.17）% vs（12.19±3.34）%],（P0.05）.The percentage in T2DM patients with microangiopathy were significantly higher than that without microangiopathy [（16.54±6.78）% vs（9.55±6.78）%,（16.18±7.63）% vs（13.93±6.83）%,（14.94±5.22）% vs（12.87±6.32）%,（24.65±9.97）% vs（16.67±7.20）%],（P0.05）.The sensitivity and specificity of CD62p for diagnosis were 93.5% and 90.9%,PNA was 60.9% and 54.5%,PlyA 65.2% and 54.5%,PMA 78.3% and 68.2%,respectively.Conclusion CD62p,PNA,PLA,PMA should be indicators of microvascular injury in T2DM.The higher sensitivity and specificity of PMA and CD62p were found for diagnosis of T2DM,and CD62p may be the preferred marker.