糖尿病慢性大血管并发症与vWF的关系

为探讨 2型糖尿病患者的慢性大血管并发症与vonWillebrand因子 (vWF)的变化特点及其临床意义 ,将1 0 6例 2型糖尿病病人根据病史与是否合并糖尿病大血管病变分为 :无并发症组 5 3例 (男 2 6例 ,女 2 7例 ) ,大血管并发症组 5 3例 (男 2 6例 ,女 2 7例 ) ,按照与糖尿病患者匹配的年龄选择正常对照组 5 6例 (男 2 8例 ,女 2 8例 )。 3组分别进行vWF的测定 ,并测定收缩压、舒张压、尿微量蛋白排泄率 (UAER)、糖化血红蛋白 (HbAIC)等指标。结果 :糖尿病患者血浆vWF水平较正常人明显升高 (P <0 .0 1 ) ,大血管并发症组的vWF较正常对照组及无并发症组显著升高(P <0 .0 1 )。多元逐步回归分析显示 ,影响糖尿病患者vWF改变的主要因素按其作用大小依次为低密度脂蛋白、糖化血红蛋白、尿微量蛋白排泄率 (UAER)的对数、收缩压。提示 :糖尿病人vWF水平的上升提示存在血管内皮功能损伤。合并有高血压、冠心病、下肢动脉硬化、血脂异常的糖尿病患者血浆vWF升高 ,表明合并大血管并发症时存在血管内皮细胞损伤。

Relationship between Chronic Macrovascular Complication and von Willebrand Factor in Type 2 Diabetic Patients

The purpose was to study the relationship between chronic macrovascular complication and von Willebrand factor (vWF) level in type 2 diabetic patients. 106 type 2 diabetic patients hospitalized were included in our study and divided into two groups. Group A: 53 type 2 diabetic patients without any vascular complications, Group B: 53 patients with macrovascular complication. The age-matched control group consisted of 56 healthy subjects. In this trial, the plasma vWF level was measured by peroxidase enzyme-linked immunosorbent assay, the other data related to diabetic macrovascular complications were also analyzed, such as systolic blood pressure, diastolic blood pressure, urinary albumin excretion rate and glycosylated hemoglobin, etc. The plasma vWF levels were significantly higher in diabetic patients than age-matched control subjects(P<0.01); the plasma vWF level in patients with macrovascular complication group rose significantly compared with control subjects and patients without macrovascular complication respectively (P<0.01). Multiple regression analysis disclosed that low-density lipoprotein (LDL), glycosylated hemoglobin, logarithm of UAER and systolic blood pressure were the primary factors which cause vWF rose up. It suggests that there is endothelial cell damage in diabetic macrovascular complication.