血栓疗养蛋白在糖尿病微血管病变中的变更.docVIP

血栓调节蛋白在糖尿病微血管病变中的变化 血栓调节蛋白在糖尿病微血管病变中的变化 2010-08-01 　刘秀珍　汪涟明　华燕吟　王舟　娄霞英　邢玉波 　　【摘要】　目的　探讨血浆血栓调节蛋白(TM)在糖尿病性肾病患者中的变化以了解其在微血管病变发病中的意义。方法　检测58例2型糖尿病患者血浆TM与内皮素(ET)的水平，并与30例正常人进行比较。结果　(1)糖尿病组血浆TM水平明显高于正常对照组(P＜0.001)，其中临床糖尿病肾病组血浆TM水平明显高于早期糖尿病肾病组(P＜0.001)及尿白蛋白正常的糖尿病组(P＜0.01)；(2)血浆TM水平与尿白蛋白排泄率、ET水平呈显著正相关(r=0.5390和0.5650，P均＜0.005)。结论　血浆TM水平测定对2型糖尿病性肾病的早期诊断和病情分析有重要的临床价值。 　　【关键词】　微血管病变　　糖尿病肾病　　血栓调节蛋白 Plasma thrombomodulin levels in patients with diabetic microangiopathy 　　HUA Yanyin,LIU Xiuzhen,WANG Lianming,et al. Department of Medicine,Zhejiang Province Peoples Hospital,Hangzhou,310014 　　【Abstract】　Objective　To measure the plasma levels of thrombomodulin (TM) in patients with diabetic nephropathy and to study the significance of TM in the pathogenesis of microangiopathy. Methods　The levels of plasma TM were measured by ELISA in 30 normal controls (NC group) and 58 cases with type 2 diabetes mellitus (DM group), including 10 cases without albuminuria (SDM group), 29 cases with microalbuminuria (EDN group) and 19 cases with macroalbuminuria (CDN group).　　Plasma　　 endothelin　　(ET)　　levels　　were　　measured　　by　　RAST simultaneously. Results　The levels of plasma TM were markedly elevated in DM, SDM, EDN and CDN groups than in NC group (P＜0.001, 0.05, 0.001 and 0.001, respectively). The plasma TM levels in CDN group were significantly higher than those in　　SDM　　and　　EDN groups (P=0.003 and P＜0.001, respectively). There was a positive correlation between plasma TM and urinary albumin excretion rate (r=0.5390,P＜0.005), and between plasma TM and plasma ET (r=0.5650, P＜0.005) in groups with diabetic nephropathy. Conclusions The measurement of plasma TM is useful in evaluating the early diagnosis and severity in type 2 diabetic nephropathy. 　　【Key words】　Microangiopathy　　Diabetic nephropathy　　Thrombomodulin (Chin J Endocrinol Metab, 1999, 15:44-46) 　　血栓调节蛋白(Thrombomodulin, TM)是存在于内皮细胞膜表面的一类糖蛋白，对血管内凝血的调节起重要作用。近年来，血浆TM已被用来作为某些疾病微血管损伤的标记物〔1，2〕。我们对58例2型糖尿病(DM)患者血浆TM进行了测定，以探讨血浆TM在糖尿病微