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目的探讨糖耐量减低(IGT)人群血小板活化状态及影响因素。方法选择IGT组33例、糖尿病组和正常对照组各30例为研究对象。采用流式细胞术(FCM)检测血小板膜蛋白CD62P、血小板激活复合物(PAC-1)阳性率和平均荧光强度(MFI);电阻抗法测定血小板数目(count)、血小板平均体积(MPV)、血小板分布宽度(PDW)及大血小板比率(P-LCR)等参数及总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)、空腹血糖(FPG)和空腹胰岛素(FIns)。结果IGT组、糖尿病组CD62P%(P<0.01)、CD62PMFI(P<0.05)、PAC-1%(P<0.01)、MPV(P<0.05)、PDW(P<0.05)及P-LCR%(P<0.05)均较正常对照组升高;IGT组与糖尿病组之间差异无统计学意义(P>0.05)。多元回归分析显示,IGT组与CD62P密切相关的因素依次为P-LCR、LDL-C、TC和体质量指数(BMI);与PAC-1相关的因素依次为P-LCR、MPV及DBP。结论IGT人群存在与糖尿病同等程度的血小板活化;LDL-C、TC、DBP及BMI是影响血小板活化的因素。
Objective To investigate the status of platelet activation in impaired glucose tolerance (IGT) and its influencing factors. Methods 33 cases of IGT group, 30 cases of diabetes mellitus group and normal control group were selected as the research object. The positive rate of platelet-activating protein complex (PAC-1) and mean fluorescence intensity (MFI) of platelet membrane protein (CD62P) were detected by flow cytometry (FCM). The platelet count, platelet mean volume (MPV) PDW, P-LCR and the levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL- C), very low density lipoprotein cholesterol (VLDL-C), fasting blood glucose (FPG) and fasting insulin (FIns). Results The levels of CD62P%, CD62PMFI, PAC-1% (P <0.01), MPV (P <0.05), PDW (P <0.05) and P-LCR% P <0.05) were higher than the normal control group; there was no significant difference between the IGT group and the diabetic group (P> 0.05). Multivariate regression analysis showed that the factors closely related to CD62P in IGT group were P-LCR, LDL-C, TC and body mass index (BMI). The factors related to PAC-1 were P-LCR, MPV and DBP. CONCLUSION: There is platelet activation in IGT population with the same degree of diabetes. LDL-C, TC, DBP and BMI are the factors affecting platelet activation.