血小板微粒在糖尿病肾病患者中的表达及其与肾脏损伤的关系  

Expression of platelet microparticles in patients with diabetic nephropathy and its relationship with renal damage

作　　者：邵雯 杜彬 杜爱翠 任召祺 SHAO Wen;DU Bin;DU Aicui;REN Zhaoqi(Department of Blood Transfusion, PLA Rocket Force Characteristic Medical Center)

机构地区：[1]火箭军特色医学中心输血科,北京100088

出　　处：《中国输血杂志》2024年第7期779-784,共6页Chinese Journal of Blood Transfusion

基　　金：国家卫生健康委基金项目(2021KYSHX02303)。

摘　　要：目的 探讨血小板微粒(platelet microparticles,PMPs)在糖尿病肾病(diabetic nephropathy,DN)患者中的表达水平及其与肾脏损伤的关系。方法 纳入30名DN患者、30名非DN的2型糖尿病患者和30名健康对照者。采用流式细胞术检测PMPs的数量和表型,采用ELISA法检测血浆肾素、血管紧张素Ⅱ(angiotoninⅡ,AngⅡ)、血管内皮生长因子(vascular endothelial growth factor,VEGF)和转化生长因子-β1(transforming growth factor-β1,TGF-β1)的水平,采用血生化检测肾脏功能。结果 DN组的PMPs数量为(1 564±346)个/μL,显著高于非DN组的(1 246±312)个/μL和对照组的(1 223±299)个/μL(P<0.05),DN组主要为表达CD62P和CD41a的PMPs,占(76.5±12.3)%。且PMPs水平和活化程度随DN进展而升高。PMPs数量与肾素等因子呈正相关(r=0.56~0.62,P<0.05),与肾小球滤过率(GFR)呈负相关(r=-0.64,P<0.05),与尿白蛋白排泄率(UAE)呈正相关(r=0.66,P<0.05),且是UAE的独立影响因素(β=12.34,P<0.05)。结论 PMPs在DN患者中表达升高,可能与肾脏损伤有关,但尚不足以证实其在DN发病机制中的作用。Objective To investigate the expression levels of platelet microparticles(PMPs) in patients with diabetic nephropathy(DN) and their relationship with renal injury.Methods Thirty DN patients,30 T2DM patients without DN and 30 healthy controls were enrolled.Flow cytometry was used to detect the quantity and phenotype of PMPs,and ELISA was used to measure the levels of plasma renin,angiotensin Ⅱ(angiotoninⅡ,AngⅡ),vascular endothelial growth factor(vascular endothelial growth factor,VEGF) and transforming growth factor-β1(transforming growth factor-β1,TGF-β1).Kidney function was determined by blood biochemistry.Results The quantity of PMPs in the DN group was(1 564±346) particles/μL,which was significantly higher than that in the non-DN group(1 246±312) particles/μL and the control group(1 223±299) particles/μL(P<0.05).The PMPs in the DN group mainly expressed CD62P and CD41a,accounting for(76.5±12.3)%.Moreover,the levels and activation of PMPs increased with the progression of DN.The quantity of PMPs was positively correlated with renin and other factors(r=0.56-0.62,P<0.05),negatively correlated with the glomerular filtration rate(GFR)(r=-0.64,P<0.05),and positively correlated with the urinary albumin excretion rate(UAE)(r=0.66,P<0.05).PMPs were also an independent influencing factor of UAE(β=12.34,P<0.05).Conclusion PMPs expression is elevated in DN patients,which may be associated with renal injury,but it is insufficient to confirm its role in the pathogenesis of DN.

关 键 词：血小板微粒 糖尿病肾病 肾脏损伤 血管紧张素系统激活 内皮功能障碍 

分 类 号：R331.143[医药卫生—人体生理学] R587.1[医药卫生—基础医学] S941.427[农业科学—水产养殖]