2型糖尿病患者血清von Willebrand因子变化与微血管并发症的关系

目的 :探讨 2型糖尿病患者的微血管内皮细胞功能损伤与微血管并发症之间的关系。方法 :从 3 3 4名 2型糖尿病患者中选择合并微血管并发症但未合并大血管并发症者 3 2人作为微血管并发症组 ,并选择年龄与之匹配的无大血管及微血管并发症 55人作为无并发症组 ,观察二组患者血清vonWillebrand因子 (vWF)水平 ,并与年龄相接近的正常对照组 ( 4 0例 )比较。结果 :血清vWF水平正常对照组 0 .92U± 0 .44U/ml;无并发症组 1.15U± 0 .42U /ml ;微血管并发症组 1.3 7U± 0 .44U/ml;三组之间均有显著性差异 (P <0 .0 5～ 0 .0 1)。多因素Logistic回归分析表明vWF、空腹血糖分别与糖尿病人是否合并微血管病变显著相关 (ExpB分别为 3 .0 2 3 ,1.3 3 7,P <0 .0 5～ 0 .0 1) ,以vWF为应变量的多元逐步回归分析表明年龄、糖尿病病程、甘油三酯分别与vWF呈显著独立正相关 (B =0 .53 ,0 .3 5,0 .2 9,P <0 .0 5～ 0 .0 1)。结论 :在糖尿病患者中存在不同程度的微血管内皮细胞的损伤 ,此变化随着微血管并发症的进展呈进行性加重。以vWF升高所反映的微血管内皮细胞损伤是一项值得临床推广的研究方法

Relationship Between von Willebrand Factor and Microangiopathic Complications in Type 2 Diabetics

To evaluate the relationship between von Willebrand F actor(vWF) and microangiopathic complications in type 2 diabetics.Method: 32 type 2 diabetic patients with microangiopathic but wi thout macroangiopathic complications were taken as microangiopathic complication group;55 type 2 diabetic patients with neither micro nor macroangiopathic comp lications and their ages match to microangiopathic complication group were as wi thout complication group;Serum vWF was measured in all patients and in normal co ntrol group( n=40 ) by ELISA.Results: The concentration of serum vWF was 0. 92±0.44 U/ml in normal control group,1.15±0.42 U/ml in without complication gr oup and 1.37±0.44 U/ml in microangiopathic complication group.There were obvio us differences among the groups( P<0.05～0.01 ).Logistic backward regression a nalysis was performed,it was shown that serum vWF,fasting bloo d glucose were remarkably correlated with microangiopathic complications(ExpB 3. 023,1.337, P<0.05～0.01 ).Multiple backward regression analysis showed that ag e,course of diabetes and triglyceride were respectively obvious positive correla tion with serum vWF(B=0.53,0.35,0.29, P<0.05～0.01 ).Conclusion: There were microcirculation and endothelial dysfunct ion in diabetic patients.Serum vWF was gradually increased associated with the m icroangiopathic complications procedure.Serum vWF might be a predictor for micro angiopathic complications in diabetic patients.