PAI-1和tPA与Ⅱ型糖尿病血管病变关系探讨

目的：以整体的观点，探讨Ⅱ型糖尿病血管病变与纤溶酶原激活物（ｔ Ｐ Ａ） 及抑制物（ Ｐ Ａ Ｉ－ １） 之间的关系。方法：选取４６ 例正常人，７１ 例Ⅱ型糖尿病患者，采用酶联免疫吸附法（ Ｅ Ｌ Ｉ Ｓ Ａ） 定量测定ｔ Ｐ Ａ 及 Ｐ Ａ Ｉ－ １ 水平。结果：单纯糖尿病组（ Ｄ Ｍ 组） ， Ｐ Ａ Ｉ－ １ 正常；并发血管病变各组， Ｐ Ａ Ｉ－ １ 比对照组升高，差异显著；合并大血管病变组（ Ｄ Ｍ＋ Ａｔｈ 组） ， Ｐ Ａ Ｉ－ １ 比 Ｄ Ｍ 组升高，差异显著；合并微血管病变组（ Ｄ Ｍ＋ Ｄ Ｎ／ Ｄ Ｒ 组） ， Ｐ Ａ Ｉ－ １ 有升高趋势，但差异不显著（ Ｐ＝ ０ ．０６７６） ； Ｄ Ｍ 组、 Ｄ Ｍ＋ Ａｔｈ 组、 Ｄ Ｍ＋ Ｄ Ｎ／ Ｄ Ｒ 组，ｔ Ｐ Ａ 比正常对照组升高，差异不显著； Ｄ Ｍ＋ Ａｔｈ组、 Ｄ Ｍ＋ Ｄ Ｎ／ Ｄ Ｒ 组，ｔ Ｐ Ａ 比 Ｄ Ｍ 组下降，差异不显著。多元回归分析结果显示， Ｐ Ａ Ｉ－ １ 与空腹胰岛素呈显著正相关关系。结论：（１） Ⅱ型糖尿病合并血管病变者 Ｐ Ａ Ｉ－ １ 水平升高；（２） Ｐ Ａ Ｉ－ １ 水平与空腹胰岛素水平呈显著正相关关系；（３） 推测ｔ Ｐ Ａ 在糖尿病血管病变的发病中系一代偿因素。

THE STUDY OF RELATIOHSHIP BETWEEN PAI-1 AND tPA WITH THE DOVELOPMENT OF VASCULAR COMPLICATIONS IN NIDDM

To investigate the relationship between plasminogen activator inhibitor (PAI-1) and tissue plasminogen activator (tPA) with the development of vascular complications in NIDDM,the levels of PAI-1 were measured by ELISA from 46 normal subjects (controls) and 71 subjects of NIDDM.The results of this research are as follows:the PAI-1 levels of NIDDM without vascular complications (DM) were normal;the PAI-1 levels were significantly increaed in every groups with vascular complications compared with controls,the differences were significant;the PAI-1 levels were significantly increased in the group with macrovascular complications (DM Ath) compared with the patients of DM,the differences were significant;the PAI-1 levels tended to be higher in the group with micro_vascular complications (DM DN/DR) than in the patients of DM,although the differences were not significant (P=0.0676);the tPA levels tended to be higher in the patients of DM and DM Ath,DM DN/DR than in the control,but no significant variation was observed between them;the tPA levels were decreased in the patients of DM Ath or DM DN/DR compared with the patients of DM,but the differences were not significant.Multiple regression analysis revealed that PAI-1 was significant positive correlativity with fasting insulin.Conclusion:(1)The PAI-1 levels were increased in NIDDM with vascular complications;(2)PAI-1 was significant positive correlativity with fasting insulin;(3)tPA levels may be a compensate factor for development of vascular complications in NIDDM.;