糖尿病肾病患者血小板GMP-140水平变化及其相关因素的研究

探讨糖尿病患者血小板GMP - 140含量变化及其相关因素与糖尿病肾病发生发展的关系。本文选取糖尿病无肾脏病组 (DM组 ) 144例 (平均病程 2 5 .5± 18.6个月 ) ,糖尿病有肾脏病变组 (DN组 ) 80例 (平均病程5 8.7± 31.6个月 ) ,以及 5 0名对照组。用放免法分别测定其血小板GMP - 140和血α1-MG、β2 -MG ;层析柱法测HBA1C ;生化法测FBG、PBG、Ch、TG、HDL、FG ;放免法测 2 4h尿ALB、IgG、α1-MG和 β2 -MG。经计算机软件处理测定结果 ,进行t检验 ,并对结果进行直线相关和多因素分析。结果表明DN组血小板GMP - 140、FG、DBP、TG、HBA1C和PBG水平 ,明显高于DM组和对照组 (P <0 .0 5 - 0 .0 0 1) ;DN组的HDL、SBP和FBG与DM组无显著性差异 (P均 >0 .0 5 ) ,高于对照组 (P <0 .0 1- 0 .0 0 1)。对 80例DN患者的血小板GMP - 140与TG、DBP和HBA1C等 ,作多因素回归分析 (P <0 .0 1)。本文提示 :(1)血小板GMP - 140含量明显增高 ,能够准确反映血小板活化、活化程度及血栓形成倾向 ,以及血小板大量活化 ,参与了肾脏微血管病变。 (2 )多因素回归分析发现 ,血TG、Ch和HBA1C是引起血小板活性增强的独立因素 ,Ⅱ型糖尿病患者的脂质代谢紊乱使血小板活性增强。 (3)血压升高可加速DN的形成和发展 ,对血小板GMP - 140含量

Changes of Platelet GMP-140 in Diabetic Nephropathy and Its Multi-factor Regression Analysis

The relation of platelet GMP-140 and its related factors with diabetic nephropathy was studied.144 patients of diabetic mellitus without nephropathy(group without DN,mean suffering duration of 25.5±18.6 months);80 with diabetic nephropathy(group DN,mean suffering duration of 58.7±31.6 months) and 50 normal controls were chosen in this research.Platelet GMP-140,plasma α1-MG，β2-MG，and 24 hour urine albumin(ALB),IgG,α1-MG，β2-MG were detected by RIA,while HBA1C via chromatographic seperation and FBG,PBG,Ch,TG,HDL,FG via biochemical methods.All the data had been processed with software on computer with t-test and linear regression,and multi-factor analysis were done also.The levels of platelet GMP-140,FG,DBP,TG,HBA1C and PBG in group DN were significantly higher than those of group without DN and normal control(P＜0.05-0.001).There were no statistical differences of HDL,SBP and FBG of group DN compared with those of group without DN(P＞0.05),while they were higher than those of normal controls.Multi-factor analysis of platelet GMP-140 with TG,DBP and HBA1C were performed in 80 patients with DN(P＜0.01).The increase of platelet GMP-140,which could be used to predict the platelet activation and its degree and the tendency of thrombosis,and the activation of plateles in a large extent might participate in the pathology of renal micrangium.Results of multi-factor analysis suggest that TG,Ch and HBA1C are the independent factors enhancing the activation of platelets.The disturbance of lipid metabolism in type Ⅱ diabetic mellitus may also enhance the activation of platelets.Elevation of blood pressure may accelerate the initiation and deterioration of DN in which change of platelet GMP-140 is an independent factor.Elevation of HBA1C and blood glucose are related closely to the diabetic nephropathy.