糖尿病病人纤溶活性变化及其对血管病变影响  

THE CHANGES OF FIBRINOLYSIS AND ITS EFFECT ON DIABETIC ANGIOPATHIES IN PATIENTS WITH DIABETES MELLITUS

作　　者：孟凡军[1,2] 张茂宏[1,2] 徐从高 

机构地区：[1]青岛医学院内科学教研室 [2]山东医科大学血液病研究室

出　　处：《青岛医学院学报》1997年第1期9-11,共3页Acta Academiae Medicinae Qingdao Universitatis

基　　金：国家自然科学基金

摘　　要：①目的探讨糖尿病（ＤＭ）病人纤溶功能改变及其对糖尿病性血管病变的影响，分析其纤溶功能紊乱的可能原因。②方法应用显色底物法测定６５例糖尿病病人血浆纤溶酶原活性（ＰＡ）、纤溶激活活性（ＦＡＡ）和纤溶抑制活性（ＦＩＡ），同时测定空腹血糖、胆固醇和甘油三酯。病人按有无血管病变和ＤＭ类型分组，并与正常人对照，应用ｔ检验和直线相关分析做统计学分析。③结果ＤＭ组ＰＡ与ＦＩＡ较对照组明显升高（ｔ＝３．３９５，３．４０１，Ｐ均＜０．００１），ＦＡＡ较对照组显著下降（ｔ＝３．２１２，Ｐ＜０．０１）。在无血管病变时，ＰＡ与对照组比较差异无显著性，而ＦＡＡ与ＦＩＡ有显著性变化，Ⅱ型糖尿病组ＦＩＡ明显高于Ⅰ型（ｔ＝２．８９３，Ｐ＜０．０１）。ＦＩＡ与高甘油三脂血症、高糖血症呈明显正相关（ｒ＝０．３０１，Ｐ＜０．０５；ｒ＝０．３２５，Ｐ＜０．０１）。④结论糖尿病病人存在纤溶功能紊乱并且是糖尿病性血管病变形成的原因之一。Objective To investigate the changes of fibrinolysis and its effect on diabetic angiopathies and analyze the possible causes of abnormal fibrinolysis. Methods With caseinolytic assay, plasminogen activation(PA), fibrinolytic activation activity(FAA) and fibrinolytic inhibition activity(FIA) were determined in 65 cases of diabetic patients, fasting plasma glucose(FPG), cholesterol(Ch) and triglyceride(TG) measured simultaneously. The patients were grouped according to the presence or abscence of diabetic angiopathies and DM type, and compared with control group. Student test and linear correlation were applied as the statistical methods. Results PA and FIA were significantly increased( t=3.395,3.401,P <0 001) and FAA was significantly decreased( t=3.212,P <0 01) in the patients as compared with control group. When without the vascular complications, PA had no significant change, but there were statistical changes in FAA and FIA. Higher FIA in NIDDM than in IDDM may be one of the causes of more vascular complications in NIDDM. The close correlation of FIA with hypertriglyceride and hyperglycemia suggested that the abnormal fibrinolysis was related to the disturbances of lipids and glucose metabolisms. Conclusion The decreased fibrinolytic capacity due to the increased plasma PA, FIA and decreased FAA exists in diabetes mellitus. It may have pathogenetic importance in diabetic angiopathies.

关 键 词：糖尿病 纤维蛋白溶解 血管病变 

分 类 号：R587.1[医药卫生—内分泌] R543[医药卫生—内科学]