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目的探讨2型糖尿病(T2DM)患者血浆中可溶性内皮细胞蛋白C受体(sEPCR)和凝血酶激活的纤溶抑制物(TAFI)水平的变化及意义。方法109例T2DM患者(T2DM组)根据尿白蛋白排泄率(UAER)分为正常白蛋白(N-UAlb)尿组(UAER<20μg/min)、微量白蛋白(Mi-UAlb)尿组(UAER20～200μg/min)和大量白蛋白(Ma-UAlb)尿组(UAER>200μg/min)。双抗体夹心ELISA法检测血浆sEPCR和TAFI浓度,并与30例正常对照(NC)组进行比较。结果血浆sEPCR和TAFI浓度T2DM组显著高于NC组(P<0.01),其中N-UAlb组明显高于NC组(P<0.05),Mi-UAlb组、Ma-UAlb组明显高于N-UAlb组(P<0.05)。尿UAERMi-UAlb组和Ma-UAlb组明显高于N-UAlb组(P<0.05)。患者血浆sEPCR和TAFI浓度与尿UAER成显著正相关(P<0.01)。结论sEPCR在一定程度上反映糖尿病血管内皮细胞的损害情况,TAFI水平增高参与糖尿病患者凝血与纤溶功能的改变。
Objective To investigate the changes and clinical significance of soluble endothelial cell protein-C receptor (sEPCR) and thrombin-activated fibrinolysis inhibitor (TAFI) in patients with type 2 diabetes mellitus (T2DM). Methods One hundred and ten patients with T2DM (T2DM group) were divided into N-UAlb urine group (UAER <20μg / min) and Mi-UAlb urine group (UAER20) according to urinary albumin excretion rate ~ 200μg / min) and a large amount of albumin (Ma-UAlb) urine (UAER> 200μg / min). The plasma levels of sEPCR and TAFI were detected by double antibody sandwich ELISA and compared with 30 normal control (NC) groups. Results Plasma sEPCR and TAFI concentrations in T2DM group were significantly higher than those in NC group (P <0.01), of which N-UAlb group was significantly higher than NC group (P <0.05), Mi-UAlb group and Ma-UAlb group was significantly higher than N-UAlb group Group (P <0.05). Urinary UAERMi-UAlb group and Ma-UAlb group was significantly higher than the N-UAlb group (P <0.05). Plasma sEPCR and TAFI concentrations were positively correlated with urine UAER (P <0.01). Conclusion sEPCR to some extent reflect the damage of diabetic vascular endothelial cells, increased levels of TAFI involved in diabetic coagulation and fibrinolysis changes.