论文部分内容阅读
目的 探讨 2型糖尿病 (DM)对氧磷脂酶 1(PON 1)和氧化低密度脂蛋白 (ox LDL)与内皮细胞和血小板功能的关系 ,以及对糖尿病肾病 (DN)发生、发展的影响。方法 用酚乙酸酯为底物的速率法测定 91例 2型DM患者血清PON 1,用ELISA法测定ox LDL ,同时测定血清一氧化氮 (NO)、血管性假血友病因子 (VWF)及血浆颗粒膜蛋白 (GMP 14 0 ) ,并与正常人作对照。以 2 4h尿白蛋白排泄率 (UAER)将DM患者分成三组。结果 血清PON 1活性在 2型DM三组中与对照组比较显著降低(P <0 0 1) ,血浆ox LDL浓度则显著升高 (P <0 0 1) ,二者在DM三组之间的差别有显著性 (P <0 0 5 )。PON 1与尿白蛋白呈显著性负相关 (P <0 0 1) ,ox LDL则与之呈显著性正相关 (P <0 0 1) ,二者之间呈负相关 (P <0 0 1)。PON 1与血NO呈正相关 ,与GMP 14 0呈显著负相关 ;ox LDL与血NO呈负相关 ,与VWF、GMP 14 0呈正相关。经Logistic回归分析 ,提示ox LDL是DN的危险因子。结论 DM的高血糖和脂代谢紊乱造成的PON 1酶活性下降以及脂质过氧化物的堆积 ,使内皮细胞的完整性及功能受损 ,同时血小板的活化程度明显增强。它们的共同作用与DN的发生、发展密切相关。
Objective To investigate the relationship between the expression of PON 1, ox LDL, endothelial cell and platelet function, and the occurrence and development of diabetic nephropathy (DN) in type 2 diabetes mellitus (DM). Methods The level of PON 1 in 91 patients with type 2 diabetes mellitus was measured by the rate method of phenol acetate. The serum oxaliplatin (LDL) was measured by ELISA. The levels of serum nitric oxide (NO), von Willebrand factor (VWF) And plasma membrane protein (GMP 14 0), and compared with normal people. DM patients were divided into three groups with 24 h urinary albumin excretion rate (UAER). Results Serum PON 1 activity was significantly decreased (P <0.01) and the level of plasma ox-LDL was significantly higher in type 2 DM group than that in control group (P <0.01) The difference was significant (P <0 05). There was a significant negative correlation between PON 1 and urinary albumin (P <0.01) and ox LDL (P <0.01) (P <0.01 ). PON 1 was positively correlated with serum NO and negatively correlated with GMP 14 0; ox LDL was negatively correlated with serum NO and positively correlated with VWF and GMP 14 0. Logistic regression analysis suggested that ox LDL was a risk factor for DN. Conclusions Decreased PON 1 activity and accumulation of lipid peroxides caused by hyperglycemia and dyslipidemia in DM may impair the integrity and function of endothelial cells and enhance the activation of platelets. Their common function is closely related to the occurrence and development of DN.