老年糖尿病患者血管内皮生长因子与血小板聚集功能的相关分析

目的探讨糖尿病患者血小板聚集功能(PAgT)与血管内皮生长因子(VEGF)的相关性,为糖尿病微血管并发症预防提供依据。方法选择大于65岁的老年糖尿病患者40例(A1组:正常白蛋白尿组20例;A2组:微量白蛋白尿组20例),中年糖尿病患者40例(B1组:正常白蛋白尿组20例;B2组:微量白蛋白尿组20例),中年健康人20例(C组)组,均于入院第三天抽取空腹静脉血测定血清VEGF及PAgT。结果B1组及A1组的血清VEGF水平及PAgT明显高于C组,具有显著性差异。A2组较A1组血清VEGF及PAgT的水平明显增高,B2组血清VEGF及PAgT较B1组增高亦具有统计学意义。A2组较B2组血清VEGF及PAgT水平明显高,差别具有显著性。糖尿病患者血清VEGF与PAgT具有相关关系。结论糖尿病早期即有血管内皮损伤,发生血管病变时则增高更为明显。这是由于高血糖导致血小板功能异常,组织缺氧引起微循环障碍,但老年糖尿病的PAgT与血清VEGF水平高于中年糖尿病患者,这是由于衰老激活了PAgT、刺激血清VEGF分泌。糖尿病患者PAgT与VEGF水平具有正相关关系(r=0.653,p<0.01)。

CHANGE AND CLINICAL IMPLICATION OF BLOOD PLATELET AGGREGATION TEST AND VASCULAR ENDOTHELIAL GROWTH FACTER IN AGED PATIENTS WITH TYPE 2 DIABETES MELLITUS

Objective To explore the change and clinical implication of blood platelet aggregation test （PAgT） 、vaseular endothelial growth fatter（VEGF） in aged patients with type 2 diabetes mellitus （DM）. Methods To measure the level of serum VEGF and PAgT in forty type 2 diabetic aged patients （ Algroup：20 with normal UAER and A2 group：20 with nephropathy） ,forty type 2 diabetic middle patients （B1 greup：20 with normal UAER and B2 group：20 with nephropathy） and twenty normal subjects （C group）. Results In A1 and B1 group PAgT and VEGF were higher than those of normal subjects （C） （p 〈 0. 01 ） ;In A2 and B2group PAgT and VEGF were obviously higher than those of A1, B1 group （p 〈 0.01 ） respectively;In A2 group PAgT and VEGF were significantly higher than those of B2 group（p 〈 0. 01 ） ;the analysis of linear correlation showed that the serum VEGF level was correlated with the PAgT in patients with type 2 diabetes mellitus （DM）. Conclusion At early stage in patients with type 2 diabetes mellitus （DM） vascular endothelial cell was injured,vessels was more injured,the increase was more in PAgT and VEGF,high blood sugar as a result of blood platelet function abnormal,hypoxia as a result of tiny circle obstruction. The result show in aged patients type 2 diabetic PAgT and VEGF were significantly higher than those of middle patients, because caducity activated blood platelet function and caducity also stimulated exudation of VEGF. In the patients of 2 type diabetes mellitus, there was a positive correlation between PAgT and serum VEGF （ r = 0. 653, p 〈 0. 01 ）. It is important for the diagnosis and therapy of DM to observe the changes of the PAgT and VEGF.