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目的 :探讨 2型糖尿病患者的微血管内皮细胞功能损伤与微血管并发症之间的关系。方法 :从 3 3 4名 2型糖尿病患者中选择合并微血管并发症但未合并大血管并发症者 3 2人作为微血管并发症组 ,并选择年龄与之匹配的无大血管及微血管并发症 55人作为无并发症组 ,观察二组患者血清vonWillebrand因子 (vWF)水平 ,并与年龄相接近的正常对照组 ( 4 0例 )比较。结果 :血清vWF水平正常对照组 0 .92U± 0 .44U/ml;无并发症组 1.15U± 0 .42U /ml ;微血管并发症组 1.3 7U± 0 .44U/ml;三组之间均有显著性差异 (P <0 .0 5～ 0 .0 1)。多因素Logistic回归分析表明vWF、空腹血糖分别与糖尿病人是否合并微血管病变显著相关 (ExpB分别为 3 .0 2 3 ,1.3 3 7,P <0 .0 5～ 0 .0 1) ,以vWF为应变量的多元逐步回归分析表明年龄、糖尿病病程、甘油三酯分别与vWF呈显著独立正相关 (B =0 .53 ,0 .3 5,0 .2 9,P <0 .0 5～ 0 .0 1)。结论 :在糖尿病患者中存在不同程度的微血管内皮细胞的损伤 ,此变化随着微血管并发症的进展呈进行性加重。以vWF升高所反映的微血管内皮细胞损伤是一项值得临床推广的研究方法
Objective: To investigate the relationship between microvascular endothelial dysfunction and microvascular complications in type 2 diabetic patients. METHODS: Thirty-two patients with type 2 diabetes mellitus who were complicated by microvascular complications without macrovascular complications were selected as the microvascular complications group and 55 matched age-matched macrovascular and microvascular complications As a non-complication group, serum von Willebrand factor (vWF) levels in two groups were observed and compared with the normal control group (40 cases). Results: The level of vWF in serum was 0.92U ± 0.44U / ml in normal control group, 1.15U ± 0.42U / ml in uncomplicated group, 1.3 7U ± 0.44U / ml in microvascular complications group, Significant difference (P <0.05 ~ 0.01). Multivariate logistic regression analysis showed that vWF and fasting blood glucose were significantly correlated with diabetic patients with or without microvascular disease (ExpB, respectively, 3.303, 1.337, P <0.05-0.01), with vWF as Multivariate stepwise regression analysis of response variables showed that age, duration of diabetes and triglyceride were significantly and independently related to vWF (B = 0.53, 0.53, 0.29, P <0.05). 0 1). Conclusion: There are different degrees of microvascular endothelial cell injury in diabetic patients. The changes progressively aggravate with the progression of microvascular complications. Vascular endothelial growth factor (vWF) is a clinically important research method