老年糖尿病及糖尿病合并高血压时血小板内L-精氨酸/一氧化氮代谢的改变  

The changes of the L-arginine /nitric oxide pathway in the platelet in the older patients with diabetes mellitus and diabetes mellitus complicated essential hypertension

作　　者：张丽萍[1] 段留法[1] 戴智云[1] 李葭灰[1] 石淑珍[1] 刘国树[1] 

机构地区：[1]解放军总医院,北京100853

出　　处：《解放军保健医学杂志》2005年第4期211-213,共3页Journal Of Health Care And Medicine in Chinese Pla

基　　金：院十五面上科研基金资助项目

摘　　要：目的探讨老年糖尿病及糖尿病合并高血压时血小板内L-精氨酸(L-Arg)/一氧化氮(NO)代谢的改变,为临床治疗其血栓并发症提供理论依据。方法收集了我院门诊及住院的健康老年人15例,糖尿病患者15例及糖尿病合并高血压患者15例,采用放免法测定其血小板内L-Arg转运、一氧化氮合成酶(NOS)活性、NO及cGMP的含量。结果老年糖尿病及糖尿病合并高血压患者血浆NO含量、血小板内NOS活性、NO及cGMP含量均减低,与对照组比较P<0.01。经Eadie-Hafstee plot分析发现,老年糖尿病及糖尿病合并高血压患者血小板内L-精氨酸转运的最大速率(Vmax)明显低于对照组(P<0.01),而米氏常数(Km)明显增高(P<0.01)。转运效率(Vmax/Km)较对照组明显降低(P<0.01)。结论老年糖尿病及糖尿病合并高血压患者血小板L-Arg转运功能明显受损,NOS活性及NO产量减低,导致血小板抗黏附和聚集的功能下降,老年糖尿病及糖尿病合并高血压患者易发生血栓并发症。Objective The goal of this study was to study the changes of the L-arginine（L-Arg） /nitric oxide（NO） pathway in the platelets in the older patients with diabetes mellitus and diabetes mellitus complicated essential hypertension. Methods 15 healthy older volunteers , 15 diabetes mellitus and 15 diabetes mellitus complicated with hypertension were collected. The changes of L-Arg transport,the activity of nitric oxide synthase （NOS） and the production of NO and cGMP were measured by radioimmunoassay. Results The production of NO in plasma and in platelets, activity of NOS and concentration of cGMP in platelets in the older patients with diabetes mellitus and diabetes mellitus complicated essential hypertension were decreased compared with those in contract group（ P 〈 0.01 ）. By Eadie-Hafstee plot analysis we found that the maximum transport velocity （Vmax） of L-arginine transport in patients with diabetes mellitus and diabetes mellitus complicated essential hypertension were diminished compared with those in contract group. Michael＇s constant （Km） of patients with diabetes mellitus and diabetes mellitus complicated essential hypertension was increased statistically compared with that of contract group （ P 〈 0.01 ）. Conclusions The dysfunction of L-Arg/NO pathway was serious in the patients with diabetes mellitus and diabetes mellitus complicated with hypertension leading to dysfunction of anti-adherence and anti-congregation of platelets. So it is important for us to give antiplatelet drugs and No donor besides antihypertensive drugs and antidiabetic drugs in patients with diabetes mellitus and diabetes mellitus complicated with hypertension.

关 键 词：糖尿病 高血压 L-精氨酸 一氧化氮 血小板 

分 类 号：R587.1[医药卫生—内分泌]