Lp-PLA_2血小板相关因子与2型糖尿病合并高血压病的相关性研究

Study on the Correlation between Lp-PLA_2 Platelet-associated Factors and Type 2 Diabetes Mellitus Complicated with Hypertension

目的探讨脂蛋白相关性磷脂酶A_2(Lp-PLA_2)、血小板相关因子与2型糖尿病合并高血压病患者的相关性。方法连续入选我院2型糖尿病患者共102例,分为2型糖尿病合并高血压病组(n=50)、单纯2型糖尿病组(n=52),以及同期住院的单纯高血压病组(n=30)、体检健康对照组(n=30)。记录四组患者一般资料、生化指标及血小板相关因子--血小板计数(PLT)、血小板分布宽度(PDW)、平均血小板容积(MPV)及大血小板比率(P-LCR)水平,并测定Lp-PLA_2水平。结果四组间性别、年龄、ALT、AST、Scr、BUN、TCH比较,差异无统计学意义(P>0.05)。2型糖尿病合并高血压病患者的Lp-PLA_2及PDW、MPV、PLCR水平较单纯2型糖尿病患者、单纯高血压病组及健康对照组升高,差异有统计学意义(P<0.05);PLT较单纯2型糖尿病组、单纯高血压病组及健康对照组降低,差异有统计学意义(P<0.05)。Lp-PLA_2、PDW与收缩压(SBP)成正相关(P<0.05),LpPLA_2、PDW、MPW、P-LCT与糖化血红蛋白(Hb A1c)成正相关(P<0.05)。结论 Lp-PLA_2、血小板相关因子可评估2型糖尿病患者血管内皮功能状态,合并高血压病的2型糖尿病患者血管内皮功能障碍更加严重,且该严重程度与血压、血糖控制不佳的程度有关。

Objective To investigate the relationship between lipoprotein associated phospholipase A2(Lp-PLA2),platelet related factors and type 2 diabetes mellitus complicated with hypertension.Methods 102 patients with type 2 diabetes mellitus were enrolled in our hospital.The patients were divided into two groups:type 2 diabetes mellitus complicated with hypertension group(n=50),type 2 diabetes group(n=52),hypertension group(n=30)and healthy control group(n=30).The general data,biochemical parameters and platelet related factor-platelet count(PLT),platelet distribution width(PDW),mean platelet volume(MPV)and large platelet ratio(P-LCR)were recorded in the four groups,and the level of Lp-PLA2 was measured.Results There was no significant difference in the age,sex,ALT,AST,Scr,BUN,TCH among the four groups(>0.05).Type 2 diabetes mellitus and hypertension in patients with Lp-PLA2 and PDW,MPV and P-LCR levels higher than patients with type 2 diabetes mellitus,hypertension group and healthy control group increased,the difference was statistically significant(<0.05);PLT compared with type 2 diabetes group and simple hypertension group and healthy control group decreased,with statistical significance the difference(<0.05).Lp-PLA2 and PDW were positively correlated with systolic blood pressure(SBP)(<0.05),and Lp-PLA2,PDW,MPW and P-LCT were positively correlated with glycosylated hemoglobin(HbA1c)(<0.05).Conclusion Lp-PLA2 and platelet related factors can evaluate endothelial function in patients with type 2 diabetes mellitus,and endothelial dysfunction is more severe in type 2 diabetic patients with hypertension,and the severity is related to the degree of blood pressure and blood sugar control.