糖尿病肾病患者血小板GMP-140水平变化及其相关因素的研究

Changes of Platelet GMP-140 in Diabetic Nephropathy and Its Multi-factor Regression Analysis

探讨糖尿病患者血小板GMP - 140含量变化及其相关因素与糖尿病肾病发生发展的关系。本文选取糖尿病无肾脏病组 (DM组 ) 144例 (平均病程 2 5 .5± 18.6个月 ) ,糖尿病有肾脏病变组 (DN组 ) 80例 (平均病程5 8.7± 31.6个月 ) ,以及 5 0名对照组。用放免法分别测定其血小板GMP - 140和血α1-MG、β2 -MG ;层析柱法测HBA1C ;生化法测FBG、PBG、Ch、TG、HDL、FG ;放免法测 2 4h尿ALB、IgG、α1-MG和 β2 -MG。经计算机软件处理测定结果 ,进行t检验 ,并对结果进行直线相关和多因素分析。结果表明DN组血小板GMP - 140、FG、DBP、TG、HBA1C和PBG水平 ,明显高于DM组和对照组 (P <0 .0 5 - 0 .0 0 1) ;DN组的HDL、SBP和FBG与DM组无显著性差异 (P均 >0 .0 5 ) ,高于对照组 (P <0 .0 1- 0 .0 0 1)。对 80例DN患者的血小板GMP - 140与TG、DBP和HBA1C等 ,作多因素回归分析 (P <0 .0 1)。本文提示 :(1)血小板GMP - 140含量明显增高 ,能够准确反映血小板活化、活化程度及血栓形成倾向 ,以及血小板大量活化 ,参与了肾脏微血管病变。 (2 )多因素回归分析发现 ,血TG、Ch和HBA1C是引起血小板活性增强的独立因素 ,Ⅱ型糖尿病患者的脂质代谢紊乱使血小板活性增强。 (3)血压升高可加速DN的形成和发展 ,对血小板GMP - 140含量?

The relation of platelet GMP-140 and its related factors with diabetic nephropathy was studied. 144 patients of diabetic mellitus without nephropathy(group without DN, mean suffering duration of 25.5±18.6 months);80 with diabetic nephropathy(group DN, mean suffering duration of 58.7±31.6 months) and 50 normal controls were chosen in this research. Platelet GMP-140, plasma α 1-MG,β 2-MG,and 24 hour urine albumin(ALB),IgG, α 1-MG,β 2-MG were detected by RIA, while HBA 1C via chromatographic seperation and FBG, PBG, Ch, TG, HDL, FG via biochemical methods. All the data had been processed with software on computer with t-test and linear regression,and multi-factor analysis were done also. The levels of platelet GMP-140, FG, DBP, TG, HBA 1C and PBG in group DN were significantly higher than those of group without DN and normal control( P <0.05-0.001). There were no statistical differences of HDL, SBP and FBG of group DN compared with those of group without DN( P >0.05),while they were higher than those of normal controls. Multi-factor analysis of platelet GMP-140 with TG, DBP and HBA 1C were performed in 80 patients with DN( P < 0.01 ). The increase of platelet GMP-140, which could be used to predict the platelet activation and its degree and the tendency of thrombosis, and the activation of plateles in a large extent might participate in the pathology of renal micrangium. Results of multi-factor analysis suggest that TG, Ch and HBA 1C are the independent factors enhancing the activation of platelets. The disturbance of lipid metabolism in type Ⅱ diabetic mellitus may also enhance the activation of platelets. Elevation of blood pressure may accelerate the initiation and deterioration of DN in which change of platelet GMP-140 is an independent factor. Elevation of HBA 1C and blood glucose are related closely to the diabetic nephropathy.