血管内皮损伤标记物在糖尿病肾病患者中的变化  

The Level of Markers for Vascular Endothelial Injury in Patients with Diabetic Nephropathy

作　　者：周志中[1] 吴竞生 叶山东[3] 徐修才[1] 莫蔚林[3] 

机构地区：[1]安徽省立医院中心实验室,合肥230001 [2]安徽省立医院血液科,合肥230001 [3]安徽省立医院内分泌科,合肥230001

出　　处：《血栓与止血学》2001年第3期115-117,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的:检测糖尿病患者血浆中的可溶性血管内皮细胞蛋白C受体(sEPCR)、凝血酶调节蛋白(TM)及血管性血友病因子(vWF)水平,以探讨sEPCR、TM、vWF在糖尿病肾病患者中的变化及其临床意义。方法:采用ELISA双抗体夹心法检测56例Ⅱ型糖尿病患者及20例正常对照者血浆中的sEPCR及TM水平,同时采用免疫比浊法检测同一患者及对照血浆中的vWF水平。结果:糖尿病组血浆sEPCR、TM、及vWF水平均明显高于对照组(P<0.001.P<0.01及P<0.01)。其中重型糖尿病肾病组中的sEPCR水平均显高于尿蛋白正常的糖尿病组(P<0.005),而与轻型糖尿病肾病组差异无显著性意义(P>0.05);轻型糖尿病肾病组与尿蛋白正常的糖尿病组亦无显著性差异(P>0.05);重型糖尿病组中的TM、vWF水平明显高于轻型糖尿病肾病组(P<0.005)及尿蛋白正常的糖尿病组(P<0.001);轻型糖尿病肾病组的TM水平明显高于尿蛋白正常的糖尿病组(P<0.005),而两者间vWF水平无显著性差异(P>0.05)。结论:sEPCR、TM、vWF均可在一定程度上反映糖尿病血管内皮细胞的损害情况,血浆sECR水平对糖尿病患者血管内皮损伤的早期判断以及血浆TM水平对Ⅱ型糖尿病肾病血管内皮损伤程度判断均有重要的临床参考价值。Objective: To measure the plasma levels of soluble endothelial protein C receptor(sEPCR), thrombomodulin(TM) and von willabrand factor(vWF) in patients with diabetes mellitus(DM), and to study the level and the clinical significance of sEPCR, TM, vWF in patients with diabetic nephropathy (DN). Methods: An ELISA of antibody sandwiches principles was used to detect the sEPCR, TM and im-munonephelometry assay was used to detect the vWF. Results: The levels of sEPCR, TM and vWF in DM group were significant higher than NC group (P<0.001,P<0.01 and P<0.01). The sEPCR levle in severe DN(SDN) group was significant higher than single DM (SDM) group (P< 0.005), but there was not significant difference between the SDN and mild DN(MDN) group (P>0.05), and there was not difference between the MDN group and the SDM group (P>0.05). The levels of TM, vWF in SDN group were obvious higher than MDN((P<0.005 all) and higher than SDM group (P<0.001), the TM level in MDN group was significant higher than SDM group (P<0.005), but for the vWF level, there was not significant difference between the two groups (P>0.005). Conclusion: The measurement of plasma sEPCR, TM and vWF all reflect the endothelial cell disorders in some extent, the levels of sEPCR and TM are useful in evaluating the early endothelial disorders and the severity of endothelium.

关 键 词：血管内皮 标记物 糖尿病肾病 

分 类 号：R587.2[医药卫生—内分泌]