血小板与单核细胞聚合物在2型糖尿病患者血管并发症诊断中的意义

Significance of circulating platelet-monocyte aggregates in vascular complications diagnosis of type 2 diabetes mellitus

目的探讨血小板与单核细胞聚合物（platelet—monocyte aggregates，PMA）在2型糖尿病（type 2 diabetes mellitus，T2DM）患者血管病变诊断中的意义。方法应用荧光标记单抗流式细胞术对94例T2DM患者（按有无血管并发症分为有血管并发症组64例和无血管并发症组30例）和42例健康刘照者血清中PMA表达率及实验室常规检测指标进行分析。结果T2DM患者组血清中的PMA表达率明显高于健康对照组，且差异有统计学意义（P〈0．01）。有血管病发症组患者血清中的PMA表达率高于无血管病发症组，且两组间差异亦有统计学意义（P=0．015）；糖尿病患者血管病变损伤区域数量≥2时，其PMA表达率明显高于无血管病变患者组，且差异均有统计学意义（P均〈0．05）。PMA表达率与RBC、WBC、HGB、高密度脂蛋白胆固醇等均有一定相关性（P均〈0．05）。受试者工作特征曲线显示PMA表达率为24．72％时，对T2DM血管并发症诊断的灵敏度为71．9％，特异性为73．8％，曲线下面积为0．754。结论T2DM患者血清中的PMA表达率明昆升高，日升高的程度与糖尿病血管病变数量有关。

Objective To evaluate the significance of platelet-monocyte aggregates （PMA） in vascu- lar complications diagnosis of type 2 diabetes mellitus （T2DM） patients. Methods 94 T2DM patients were di- vided into two groups according to their vascular complication including 64 patients with vascular complications （group A ） and 30 patients without vascular disease （group B）. 42 healthy age-matched people were selected as the normal controls. PMA levels were analyzed with fluorescent labeling flow cytometry. Results The PMA expression rate of T2DM group was significantly higher than that of normal control group, and the difference had statistical significance（P〈 0.fll ）. The PMA expression rate in group A was higher than in group B, and the dif- ference had statistical significance （P= 0.015）. When the degree of diabetic vascular disease damaged areas was larger than 2 in patients with T2DM, the PMA expression rate were significantly higher than diabetes with- out vascular complications group and the differences all had statistical significance （Pall〈 0.05 ）. The PMA ex- pression rate had correlations with RBC, WBC, HGB and high density lipoprotein cholesterol （Pall〈 0.05）. The diagnostic sensitivity was 71.9%, specificity was 73.8% when the cut-off value of PMA expression was 24.72% according to the receiver operating characteristic curve and the area under curve was 0.754. Conclusion The serum level of PMA in T2DM is significantly increased and the increasing degree is closely correlated with vascular disease.