2型糖尿病患者血浆可溶性内皮细胞蛋白C受体和血栓调节蛋白的变化  

Changes of plasma soluble endothelial cell protein C receptor and thrombomodulin levels in patients with type 2 diabetes mellitus

作　　者：叶山东[1] 李素梅[1] 周志中[2] 吴竞生 陈超[1] 陈若平[1] 莫蔚林[1] 

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

出　　处：《中国实验诊断学》2001年第6期304-306,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的 探讨２型糖尿病（２－ＤＭ）患者血浆可溶性内皮细胞蛋白Ｃ受体（ｓＥＰＣＲ）和血栓调节蛋白（ｓＴＭ）的变化及其临床意义。方法 采用酶联免疫双抗体夹心法测定７４例２－ＤＭ患者和２９例正常对照组（Ｋ组）ｓＥＰＣＲ和ｓＴＭ，并根据２４ｈ尿白蛋白（２４ｈＵＡＥ）分为 Ａ组（ｎ＝３６，２４ｈＵＡＥ＜３０ｍｇ）、Ｂ组（ｎ＝２４，２４ｈＵＡＥ３０～３００ ｍｇ）和 Ｃ组（ｎ＝１４，２４ｈＵＡＥ≥３００ｍｇ）。结果 与Ｋ组比较，ＤＭ患者血浆ｓＥＰＣＲ和ｓＴＭ显著升高，Ｐ＜０．０５和Ｐ＜０．０１；分组比较，Ａ组ｓＥＰＣＲ和ｓＴＭ水平无显著差异，Ｂ组显著升高（Ｐ＜０．０５和＜０．０１），Ｃ组更进一步升高，Ｐ值分别小于 ０．０１和 ０．００１；ｓＥＰＣＲ与ｓＴＭ、２４ｈＵＡＥ和糖化血红蛋白呈显著正相关（Ｐ＜０．０５），ｓＴＭ与２４ｈＵＡＥ（Ｐ＜０ ．０１）和糖化血红蛋白（Ｐ＜０．０５）呈显著正相关；ｓＥＰＣＲ和ｓＴＭ与ＤＭ病程、空腹血糖、血脂和年龄均无相关性。结论ＳＥＰＣＲ和ｓＴＭ升高与ＤＭ血管病变的发生和严重程度相关，是反映血管内皮细胞功能的良好指标，并可能参与其高凝状态的形成。Objective To investigate the changes and clinical significance of plasma soluble endothelial cell protien C receptor (sEPCR) and thrombomodulin (sTM) in patients with type 2 diabetes mellitus. Methods sEPCR and sTM were measured in 74 type 2 diabetics and 29 control subjects(group K) by an ELISA of antibody-sandwiched principle, then 74 patients were subdivided into three groups according to 24 h urinary albumin excretion(24hUAE): group A( n = 36,24hUAE< 30mg) , group B( n = 18, 24HUAE 30~300mg) and group C(n= 20, 24hUAE≥300mg). Results Compared with group K, sEPCR(P<0.05) and sTM(P<0.01) levels increased significantly in 74 diabetics and compared in the three groups, the two levels increased in group B, and further increased in group C, P<0.01 and P<0.001, but had no obvious change in group A; sEPCR was positively re-lated to 24hUAE and glycosylated hemoglobin Alc(P<0.05), sTM also had significantly positive relationship with 24hUAE(P <0.01)and glycosylated hemoglobin Alc(P<0.05), but not with the diabetic course, fasting glucose, blood lipid and age in dia-betic patients. Conclusion The increases of plasma sEPCR and sTM were related to the development and progression of vascular disease , were the sensitive markers for the vascular endothelial cell dysfunction , and maybe contribute to in some extent the hy-percoagulant state in diabetics.

关 键 词：Ⅱ型糖尿病 内皮细胞蛋白C受体 血栓调节蛋白 内皮细胞 白蛋白 

分 类 号：R587.1[医药卫生—内分泌]