2型糖尿病病人血浆可溶性内皮细胞蛋白C受体和血栓调节蛋白的变化

目的 探讨2型糖尿病(2-DM)病人血浆可溶性内皮细胞蛋白C受体(sEPCR)和血栓调节蛋白(sTM)的测定及其临床意义。方法 采用酶联免疫双抗体夹心法测定74例2-DM病人和20例正常对照组(C组)sEPCR和sTM,并根据24 h尿白蛋白(24 h UAE)分为A组(n=36,24 h UAE<30 mg)、B组(n=18,24 h UAE<30～300 mg)和C组(n=20,24 h UAE≥300 mg)。结果 与C组比较,DM病人血浆sEPCR和、sTM显著升高,P<0.05和P<0.01;分组比较,A组sEPCR和sTM水平无显著差异,B组显著升高(P<0.05和P<0.01),C组更进一步升高,P值分别<0.01和0.001;sEPCR与sTM、24 h UAE和糖化血红蛋白呈显著正相关(P<0.05),sTM与24 h UAE(P<0.01)和糖化血红蛋白(P<0.05)呈显著正相关;sEPCR和sTM与DM病程、空腹血糖、血脂和年龄均无相关性。结论 sEPCR和sTM升高与DM血管病变的发生和严重程度相关,是反映血管内皮细胞功能的良好指标,并可能参与其高凝状态的形成。

Changes of plasma solubk endithelial cell protien C receptor and thrombomodulim levels in patients with type 2 diabetes mellitus

Objective To investigate the measurement and clinical significant of plasma soluble endothelial cell protien C receptor(sEPCR) and thrombomodulin(sTM) in patients with type 2 diabetes mellitus. Methods sEPCR and sTM were measured in 74 type 2 diabetics and 20 control subjects( group K) by an ELISA of antibody-sandwiched principle, then 74 patients were subdivided into three groups according to 24 hour urinary albumin excre-tion(24hUAE) ,they were group A( n = 36,24hUAE<30mg),group B( n = 18,24hUAE 30~300mg) and group C (n =20,24hUAE≥300mg).Results Compared with group K,sEPCR(P<0.05) and sTM(P<0.01) levels in-creased signifcantly in 74 diabetics and group B,and increased further in group C,P<0.01 and P<0.001 ,but had no obvious change in group A;sEPCR was related to positively 24hUAE and glycosylated hemoglobin Alc(P< 0.05),sTM also had significant relationship with 24hUAE(P< 0.01) and glycosylated hemogolobin ( P < 0.05 ) , but not with the diabetic course,fasting glucose serun lipid and age in diabetic patients. Conclusion The increases of plasma sEPCR and sTM was related to the development and progression of vascular cisease, were the sensitivity markers for the vascular endothelial cell dysfunction, and may be contribute to in some extent the hypercoagulant state in diabetics.