2型糖尿病患者血浆t-pA、PAI活性和D-dimer水平的变化

The change in tissue plasminogen activator(t-pA),tissue plasminogen activator inhibitor activity and D-dimer level in T_2 DM patients plasma

目的 :探讨T2DM患者血浆组织纤溶酶原激活剂 (t - pA)、组织纤溶酶原激活剂抑制剂 (PAI)活性和D -二聚体(D -dimer)水平变化及意义。方法:根据WHO诊断糖尿病的标准和分型 ,选择89例T2 DM微血管病变病人,根据尿白蛋白(UAER)排泄率分为单纯糖尿病组(DM)(UAER<20μg/min)、微量白蛋白尿组(DN1)(UAER=20μg-200μg/min)和临床蛋白尿组(DN2)(UAER>200μg/min)。此外 ,还选择了38例DM2 大血管病变病人 (DM +A组 )。采用发色底物显色法测定血浆t-pA和PAI的活性 ,酶联免疫双抗体夹心法定量血浆D -dimer的水平。结果:(1)对照组、DM、DN1 和DN2 组血浆t-pA活性递减 ,PAI的活性和D -dimer水平递增 ,各组比较有显著性差异。但DM组血浆D -dimer水平与对照组比较无显著性差异。(2)DM +A组血浆t- pA活性降低 ,PAI活性和d -dimer水平升高 ,与DM组比较有显著性差异。(3)t- pA与UAER呈负相关 ,PAI和D -dimer与UAER呈正相关。空腹血糖 (FBG)进入纤溶指标(t - pA、PAI、D -dimer)3个变量的回归方程。结论 :T2DM患者血浆t- pA活性降低、PAI活性升高和D

Objective:To investigate the change in tissue plasminogen activator(t-pA),plasminogen activator inhibitor and the D-dimer level in T 2 DM patient plasma.Methods:According to DM diagnosis criterion by WHO,Screeing89patients of T 2 DM with microvascular complication who were divided into three groups:DM group(UAER<20μg/min),DN 1 group(UAER=20-200μg/min)and DN 2 group(UAER>200μg/min)and38patients of T 2 DM with macrovascular complication(DM+A).The t_PA and PAI activity were detected with substrate chromophrous assay.The D_dimer level was measured with ELISA.The UAER was evaluated with radioimmunoassay.Results:(1)In control,DM,DN 1 and DN 2 groups,there was a reducˉing tendency in t-pA activity while a progressive tendency in PAI activity.The D-dimer level in plasma was elevated in T 2 DM patients.A significant difference was found when comˉparison was made to each other between DM,DN 1 and DN 2 groups(P<0.01).No difference in D-dimer was found between DM and control groups.(2)The t-pA activity was reduced(P<0.05),while PAI activity and D-dimer level elevated(P<0.01)in DM+A group when compared with DM group.(3)The data suggest that UAER showed a negative correlation witht-pA while a positive one with PAI activity and D-dimer level respectivelly.In stepwise multiple regression analysis,the data also suggest that fasting blood glucose(FBG)was a deˉterminant of t-pA,PAI and D-dimer.Conclusion:The t-pA activity was reduced while PAI activity and D-dimer level were elevated in T 2 DM patients.The results suggest that the changes seem to be significantly correlated with microvascular and macrovascular complications.