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目的 探讨Ⅱ型糖尿病患者血小板活化与微血管病变的关系。方法 应用流式细胞术测定 5 1例Ⅱ型糖尿病患者 (其中微血管病变者 2 7例 ,无微血管病变者 2 4例 )及 2 9名正常对照组的血小板糖蛋白 ,包括α颗粒膜糖蛋白 (CD6 2p)、溶酶体颗粒膜糖蛋白 (CD6 3)、血小板膜表面糖蛋白(CD41、CD6 1、CD42b)、凝血酶敏感蛋白 (TSP) ,同时用放免法检测血浆内皮素和胰岛素。结果 糖尿病组血小板CD6 2P、CD6 3、TSP阳性的百分率 [(1 35± 0 70 ) %、(5 0 4± 2 73) %、(76 5± 9 1) % ]和CD41、CD6 1的平均荧光道数 (MnX) [(14 2 2± 6 0 3) %、(6 5 4± 1 73) % ]显著高于正常对照组 [(0 5 4±0 34 ) %、(2 84± 1 12 ) %、(6 6 3± 8 4) %、(10 43± 1 70 ) %、(4 36± 0 6 2 ) % ](P <0 0 0 5 ) ,有微血管病变组高于无微血管病变组 (P <0 0 5 )。糖尿病组的血小板CD42b的阳性百分率显著低于正常对照组(P <0 0 0 5 )。但有无微血管病变组间差异无显著意义。血小板CD6 2P ,CD6 3,CD6 1,TSP与血浆内皮素呈显著正相关 (r分别为 0 45 ,0 47,0 34和 0 30 ,P均 <0 0 5 )。结论 活化血小板测定对于糖尿病微血管病变的早期诊断具有重要的临床应用和研究价值
Objective To investigate the relationship between platelet activation and microangiopathy in type 2 diabetic patients. Methods Flow cytometry was used to determine platelet glycoproteins in 51 patients with type 2 diabetes mellitus (27 with microvascular disease, 24 with no microvascular disease) and 29 normal controls, including α-granule membrane glycoprotein CD6 2p), lysosomal granular membrane glycoprotein (CD6 3), platelet membrane surface glycoproteins (CD41, CD6 1, CD42b) and thrombin sensitive protein (TSP) were detected by radioimmunoassay. Plasma endothelin and insulin were detected by radioimmunoassay. Results The percentages of CD6 2P, CD6 3 and TSP in diabetic group were significantly higher than those in non-diabetic group [(135 ± 0 70)%, (504 ± 2 73)%, (76 5 ± 91)%] The number of fluorescent channels (MnX) [(14 2 2 ± 6 0 3)%, (6 5 4 ± 1 73)%] was significantly higher than that of the normal control group [(544 ± 0 34)% (P <0 05). There was a significant difference between the group of microvascular disease and the group of non-microvascular disease Lesion group (P <0 05). The positive percentage of platelet CD42b in diabetic group was significantly lower than that in normal control group (P <0 05). However, there was no significant difference between the groups with or without microvascular lesions. Platelet CD6 2P, CD6 3, CD6 1 and TSP were positively correlated with plasma endothelin (r = 0 45,0 47,0 34 and 0 30 respectively, P <0 05). Conclusion Activated platelet assay has important clinical application and research value for the early diagnosis of diabetic microangiopathy