血小板活化功能对2型糖尿病患者颈动脉粥样硬化的影响

目的:探讨2型糖尿病患者血小板活化功能对颈动脉粥样硬化(CAS)的影响,以及与血糖控制水平的相关性。方法:选取234例2型糖尿病患者,监测其血压、血糖、血脂及糖化血红蛋白水平。颈部血管彩色多普勒超声检查将患者分为CAS组(102例),及未发现CAS组(132例)。将CAS组患者根据糖化血红蛋白测定水平分为血糖控制良好组(HbA1C<7%,42例),血糖控制不良组(HbA1C>7%,60例)。应用流式细胞仪和单克隆抗体技术测定CAS组和未发现CAS组不同血糖控制水平时的血小板活化功能相关指标:颗粒膜蛋白140(CD62p)、溶酶体整合膜糖蛋白(CD63)、血小板质膜表面糖蛋白GP-IIbIIIa(CD41/CD61)值。结果:2型糖尿病并发CAS组患者血小板表达CD62p、CD63、CD41/CD61较未发现CAS组患者显著升高(P<0.01),并与血糖水平呈明显相关性,在CAS组患者中HbA1C<7%患者组表达CD62p、CD63、CD41/CD61水平均较HbA1C>7%组明显降低(P<0.01)。结论:血小板活化功能指标(CD62p、CD63、CD41/CD61)在2型糖尿病并发CAS患者中明显增强,并与血糖控制水平显著相关;2型糖尿病并发CAS患者,并且血糖控制不佳患者需早期积极控制血糖,给予抗血小板治疗,预防心脑血管疾病。

Relationship between Platelet activating function and carotid atherosclerosis in type 2 diabetes

Objective： To study the relationship between platelet activation function and carotid athero- sclerosis in type 2 diabetes mellitus, and the correlation with blood sugar level. Methods..234 type 2 diabetes were re- cruited,blood sugar level were evaluated. Measurement of carotid intima media thickness was performed with color Doppler apparatus,they were divided into CAS group （102）, and no CAS group （132）. Will be according to the de- termination of glycosylated hemoglobin level in patients with CAS group divided into good blood sugar control （HbA1C（7%,42）,poor control of blood sugar group （HbAIC〉7%,60）. Application of flow cytometry instru- ment technology determination of CAS and no CAS group different glucose control level of platelet activating func- tion related indicators：CD62p, CD63, and CD41/CD61. Results： In patients with type 2 diabetes complicated with CAS group of platelet CD62p, CD63 and CD41/CD61 no CAS patients significantly increased （P〈0.01）, and was significantly associated with blood sugar levels,expression of CD62p,CD63 and CD41/CD61 in HbA1C level〈7% of patients group with CAS group were compared with HbAIC〉7% group significantly decreased, and there were sta- tistically significant differences （P〈0.01）. Conclusion.. Platelet activating function index （CD62p, CD63 and CD41/ CD61） obviously increased in patients with type 2 diabetes complicated with CAS, and blood sugar level were signifi- cantly related; In patients with type 2 diabetes complicated with CAS and poor blood glucose control in patients with early positive control blood sugar,antiplatelet therapy, prevent disease of heart head blood-vessel.