Ⅱ型糖尿病患者血小板膜糖蛋白及纤维蛋白原的改变

Detection of platelet membrane glycoproteins and fibrinogen binding in patients with type II diabetes mellitus

目的 观察Ⅱ型糖尿病患者血小板膜糖蛋白及纤维蛋白原结合的变化 ,确定其对判断血小板活化及血管并发症的价值。方法 用流式细胞术观察 85例Ⅱ型糖尿病患者 (有血管病变者 47例 ,无血管病变者 38例 )及 30例健康人血小板膜上P 选择素、糖蛋白 (GP)Ⅱb Ⅲa复合物、GPⅠb、GPⅡb、GPⅢa表达及纤维蛋白原结合的改变。结果 血小板膜P 选择素、纤维蛋白原结合及GPⅡb Ⅲa的表达在糖尿病患者伴血管病变者明显高于无血管病变者及正常对照 ;GPⅠb在血管病变组低于无血管病变组与对照组 ;GPⅡb、GPⅢa在 3组间比较差异均无显著性 ;所有指标在无血管病变组与正常组无明显差别。结论 血小板膜GPⅠb、GPⅡb Ⅲa复合物、纤维蛋白原结合及P 选择素对判断糖尿病病人的血小板活化以及血管病变有重要价值。

Objective To investigate platelet membrane glycoprotein expression and fibrinogen binding in patients with type Ⅱ diabetes mellitus (DM) and to decide their value in estimating the platelet activation as well as vascular complications. Methods 85 patients with type Ⅱ DM and 30 normal individuals were enrolled into this study. Platelet glycoprotein(GP)Ⅰb,GPⅡb ,GPⅢa,GPⅡb Ⅲa complex and P selectin expression as well as fibrinogen binding was analyzed by using flow cytometry. Results The platelet membrane GPⅡb Ⅲa complex, P selectin expression and fibrinogen binding were higher in the patients with vascular diseases than those of normal subjects and the patients without vascular diseases. Platelet surface GPⅠb expression in patients with vascular diseases was lower than the other two groups. On the other hand, the GPⅡb and GPⅢa were not significantly changed. There was no difference between the patients without vascular disease and the normal individuals in this respect. Conclusion The changes of platelet membrane GPⅠb, GPⅡb Ⅲa complex, P selectin and fibrinogen binding have important value in judging the platelet activation and vascular complications in patients with type Ⅱ DM.