糖尿病合并白蛋白尿患者血小板聚集功能和膜蛋白表达的变化

Changes in platelet aggregative function and glycoprotein expression in diabetics with albuminuria

目的 探讨２型糖尿病患者血小板功能改变与血管病变的关系。方法同时测定６９例２型糖尿病患者和１４例正常人（Ｋ组）血小板ＡＤＰ聚集率和血小板表面颗粒膜蛋白（ＣＤ６２Ｐ和ＣＤ６３）表达的变化，并根据２４小时尿白蛋白排泄量将糖尿病患者分为正常白蛋白尿组（Ａ组）、微量白蛋白尿组（Ｂ组）和大量白蛋白尿组（Ｃ组）。结果与Ｋ组比较，Ｂ组和Ｃ组血小板ＡＤＰ％显著升高，Ｐ值分别小于０．０５和小于０．０１；Ａ组、Ｂ组和Ｃ组血小板表面ＣＤ６２Ｐ和ＣＤ６３表达阳性率，均显著升高，以Ｃ组最高；血小板ＡＤＰ聚集率与ＣＤ６２Ｐ和ＣＤ６３表达的阳性率呈显著正相关。结论２型糖尿病患者血小板聚集功能和活化功能显著增强，尤其在伴有白蛋白尿的患者中，并参与血管病变的发生和发展。

Objective To investigate the relationship of the changes in platelet aggregative function and membrane protein expression with vascular disease in type 2 diabetics. Methods The ADP--induced platelet aggregative rate (ADP% ) and the glycoprotein expression (CD62P and CD63) of platelet surface were measured in 69 type 2 diabetics and 14 control subjects (group K). 69 diabetics were divided into group A (normoalbuminuria),group B (microalbuminuria) and group C (macroalbuminuria) according to their 24 urinary albumin excretion. Results. As compared with group K,platelet ADP% increased markedly in group B and group C(P<0. 05 and P<0. 01,respectively);Platelet surface positive expressive rates of CD62P and CD63 raised significantly in all three diabetic groups,the highest in group C ; The platelet ADP% had significant positive relationship with CD62P and CD63 expressive rates in platelet surface in daibetics. Conclusion There exist enhanced platelet aggregative function and platelet activation in type 2 diabetics, especially in patients with albuminuria. These may contribute in some extent to the development and progression of their vascular disease.