糖尿病患者血小板膜糖蛋白和vWF表达与微血管病变的关系研究

Relationship between expression of platelet glycoprotein and vWF microangiopathy in type 2 diabetes mellitus

目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血小板膜糖蛋白表达与血管性假血友病因子(von Willebrand Factor,vWF)的关系以及它们在糖尿病微血管并发症中的作用。方法以131例T2DM患者为研究对象,根据尿蛋白排泄率(UAER)、眼底镜检查和肌电图检查分为糖尿病微血管病变组和糖尿病无微血管病变组。应用流式细胞仪(flow cytometry)检测131例2型糖尿病患者及130名正常对照组个体的血小板膜糖蛋白,同时酶联免疫吸附双抗夹心法(enzyme linked immunosorbent assay)检测血浆vWF水平,并对各种微血管并发症的相关危险因素行Logistic回归分析。结果糖尿病组CD62p、CD63阳性百分率和CD41、CD61的平均荧光道数(MnX)与正常对照组比较差异有统计学意义;微血管病变组高于无微血管病变组;糖尿病组CD42b的阳性百分率低于正常对照组,有无微血管病变间差异无统计学意义。糖尿病组血浆vWF水平(1398±69)高于正常对照组(978±67)P<0.01,有微血管病变组(1657±78)高于无微血管病变组(1243±67)P<0.01;经相关分析显示:CD62p、CD63、CD61与vWF呈正相关(r分别为0.4665、0.4556和0.3814,P<0.05。结论 CD61、CD62p、CD63和vWF在糖尿病合并微血管病变患者中显著升高,提示血小板膜糖蛋白可能参与了糖尿病合并微血管并发症的病理发生过程。

[ Objective ] To explore the relationship between expression of platelet glycoprotein, vWF and microangiepathy in patients with type 2 diabetes mellitus. [ Methods ] According to the results of urine albumin excretion rate, ophthalmoscope examination and nerve conduction velocity test, nephropathy, retinopathy and neuropathy were defined respectively. The level of platelet glycoprotein was detected by flow cytometry in 131 patients with type 2 diabetes mellitus and 130 normal controls. The plasma vWF was detected by enzyme linked immunosorbent assay （ELISA）. Platelet glycoprotein and other factors related to diabetes microvascular complications were analyzed by multiple stepwise logistic regressive analysis. [Results] The positive percent of platelet CD62p, CD63, and MnX of CD41,CD61 in type 2 diabetes mellitus were and respectively, which was significantly higher than those in normal controls respectively. The positive percent of platelet CD62p, CD63, and MnX of CD41, CD61 in patients with microangiopathy were significantly higher than those in patients without microangiopathy. The positive percent of platelet CD42b in type 2 diabetes mellitus was significantly lower than those in normal controls. The plasma level of vWF in type 2 diabetes mellitus increased significantly in comparison controls. There was a positive correlation between CD62p, CD63, CD61 and plasma vWF0=0.466 5,0.455 6 and 0.381 4 respectively, P 〈0.05. The plasma level of vWF in patients with microangiopathy were significantly higher than those in patients without mieroangiopathy P 〈0.05. [ Conclusion ] These results suggest that the platelet glyeoprotein may participate microangiopathy in patients with type 2 diabetes mellitus.