糖尿病患者血小板膜糖蛋白的改变及其临床意义  

Alterations of platelet membrane glycoproteins in patients with diabetes mellitus and their clinical significance

作　　者：韩悦[1,2] 王兆钺[1,2] 王爱青[1,2] 朱明清[1,2] 吕国萍[1,2] 茅丹[1,2] 蔡鑫元[1,2] 赵益明[1,2] 阮长耿[1,2] 

机构地区：[1]苏州医学院附属第一医院江苏省血液研究所 [2]苏州市第四人民医院内分泌科

出　　处：《中华血液学杂志》1999年第3期127-129,共3页Chinese Journal of Hematology

摘　　要：目的观察Ⅱ型糖尿病患者血小板膜糖蛋白的变化及其临床意义。方法应用流式细胞术（ＦＣＭ）观察７０例Ⅱ型糖尿病患者及２８名正常人血小板膜上ＧＰⅠｂ、Ⅱｂ、Ⅲａ及Ｐ选择素的表达。以免疫放射法（ＩＲＭＡ）测定血小板膜Ｐ选择素分子数，并以酶联免疫法（ＥＬＩＳＡ）对血浆中的Ｐ选择素进行检测。结果ＦＣＭ测得的血小板膜上Ｐ选择素表达阳性率，糖尿病伴血管病患者为（１０．２８±４．８６）％，明显高于正常人的（３．７５±１．８３）％（Ｐ＜０．０１）及无血管病变者的（４．２５±２．２９）％（Ｐ＜００１）。用ＩＲＭＡ法测得的结果与ＦＣＭ类似。血浆中Ｐ选择素浓度伴血管病变组（６．１８±３．２０）μｇ／Ｌ亦高于正常对照组的（３．４３±１．５６）μｇ／Ｌ（Ｐ＜０．０５）及无血管病变组的（３．７１±２．１２）μｇ／Ｌ（Ｐ＜００５）。相反，血小板上ＧＰⅠｂ的表达在糖尿病伴血管病变组为（８６．３５±１１．００）％明显低于正常对照组的（９２６３±７．５５）％（Ｐ＜０．０５）。而血小板ＧＰⅡｂ、Ⅲａ的表达无改变。结论有血管病变的Ⅱ型糖尿患者血小板膜上和血浆中Ｐ选择素升高，而ＧＰⅠｂ降低。Objective To investigate changes of platelet glycoproteins in patients with diabetes mellitus(DM) type Ⅱ and their clinical significance. Methods Seventy DM patients and 28 normal individuals entered in this study. The platelet glycoproteins Ⅰb, Ⅱb, Ⅲa and P selectin were analyzed by flow cytometry (FCM). Platelet surface P selectin was measured by Immunoradiometric analysis (IRMA),and plasma P selectin concentration by ELISA. Results On FCM, the P selectin expression on platelets of patients with vascular diseases [(10.28±4.86)%] was higher than that of normal subjects [(3.75±1.83)%] (P<0.01) and patients without vascular diseases [(4.25±2.29)%] (P<0.01). Similar results were obtained using IRMA.Plasma P selectin concentration in patients with vascular diseases [(6.18±3.20)μg/L] was higher than that of control group [(3.43±1.56)μg/L](P<0.05) and that of patients without vascular diseases [(3.71±2.12)μg/L] (P<0.05). On the contrary, the platelet surface GPⅠb expression in patients with vascular diseases [(86.35±11.00)%] was remarkably lower than that of normal subjects [(92.63±7.55)%] (P<0.05), while platelet GPⅡb and Ⅲa were not changed in any cases. Conclusion The P selectin levels in plasma and on platelet surface were increased while platelet membrane GPⅠb was decreased in DM type Ⅱ patients with vascular events.

关 键 词：糖尿病 NIDDM 血小板膜 流式细胞术 糖蛋白 

分 类 号：R587.1[医药卫生—内分泌]