·糖尿病临床研究·

　　基金项目：国家自然科学基金资助重大研究计划项目(0608216)

　　作者单位：830054乌鲁木齐,新疆医科大学第一附属医院神经康复科(古丽娜孜·那比尔、王宝兰);新疆医科大学(哈木拉提·吾甫尔)

　　通讯作者：哈木拉提·吾甫尔，E-mail: yjs02@xjmu.edu.cn

　　2型糖尿病患者血栓前状态的变化及临床价值

　　古丽娜孜·那比尔 王宝兰 哈木拉提·吾甫尔

　　【摘要】目的探讨T2DM患者血栓前状态包括血小板表面CD41，CD62p表达，内皮细胞损伤标志物和凝血指标的变化及其临床价值。方法用流式细胞术测定患者血小板表面CD41，CD62p;用放射免疫法检测血清内皮素-1(ET-1);用ELISA法检测血浆组织纤溶酶原激活物(t-PA)及其抑制物(PAI-1);全自动血凝分析仪检测凝血四项即血浆纤维蛋白原(FIB)水平、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)。结果DM组血小板表面CD62p的表达、血浆PAI-1、FIB三项指标均较正常对照组(NC组)增高(P<0.05)，而t-PA水平较NC组降低(P<0.05);DM组APTT、PT明显缩短(P<0.05)。糖尿病伴血管病变组血小板表面CD62p的表达、血浆PAI-1、FIB三项指标均较不伴血管病变组增高(P<0.05);糖尿病伴血管病变组APTT及TT较不伴血管病变组明显缩短(P<0.05)。结论血栓前状态若干相关分子标志物即ET-1、CD41、CD62p、t-PA、PAI-1及凝血四项的变化可能有助于预测DM血管并发症发生和发展及判断血管病变程度。

　　【关键词】糖尿病血管病变;血栓形成倾向 ;内皮细胞;血液凝固试验

　　doi:10.3969/j.issn.1006-6187.2012.05.013

　　Changes and their clinical significance of prethrombotic state in patients with type 2 diabetesGULNAZ · Nabi, WANG Bao-lan, HALMURAT·Hupur. Neurorehabilitation Department, The First Affiliated Hospital of Xinjiang Medical University, Urumchi 830054, China

　　Corresponding author: HALMURAT·Hupur, E-mail: yjs02@xjmu.edu.cn

　　【Abstract】ObjectiveTo observe the changes and their clinical significance of prethrombotic state (PTS), including the expressions of CD41 and CD62p on the surface of platelets, the markers of injured endothelial cells, and the coagulation indices in the T2DM patients.MethodsThe expressions of CD41 and CD62p were tested by flow cytometer. The level of serum endothelin-1 (ET-1) was determined by radioimmunoassay (RIA). The levels of plasma tissue plasminogen activator (t-PA) and its inhibitor-1 (PAI-1) were detected by ELISA. The level of plasma fibrinogen (FIB), the activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) were tested by a coagulation analyzer.ResultsCompared with the control group, the CD62P expression and the levels of PAI-1 and FIB in the diabetes group were all increased (P<0.05), while the level of t-PA was decreased in the diabetes group (P<0.05), and APTT and PT were significantly shortened in the diabetes group (P<0.05). The CD62P expression and the levels of PAI-1 and FIB in the diabetes with angionosis group were all increased than those in the diabetes without angionosis group (P<0.05). APTT and PT were significantly shorter in the diabetes with angionosis group than those in the diabetes without angionosis group (P<0.05).ConclusionThe related markers of prethrombotic state, such as ET-1, GMP-140, t-PA and PAI-1, and the changes of coagulation indices are important for early discovery of diabetic angionosis and judgment of its severity.

　　【Key words】Diabetic angionosis; Thrombophilia; Endothelial cells; Blood coagulation tests