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目的 :为进一步阐明糖尿病 (DM)患者血小板活化状态及抗血小板药物噻氯匹定的治疗作用。方法 :采用流式细胞术检测了 4 5例 2型糖尿病患者及 2 6例健康志愿者 (对照组 )血小板表面血小板膜糖蛋白 (GP)Ⅰb ,GPⅡb ,P 选择素及血小板激活复合物 1(PAC 1)表达 ,并对其中 2 0例 2型DM患者应用噻氯匹定治疗 (0 2 5g ,qd) 2wk ,观察对上述指标的影响。结果 :DM患者P 选择素及PAC 1表达的荧光强度较对照组明显升高 ,而GPⅠb表达的荧光强度较对照组下降 (P =0 0 14 ) ,GPⅡb表达则无明显改变 (P =0 2 85 )。噻氯匹定治疗 2wk可使DM患者P 选择素及PAC 1的表达明显下降 ,对GPⅡb表达则无明显影响(P =0 815 ) ,GPⅠb表达则上升 (P =0 0 11)。结论 :2型DM患者血小板活化增强 ,出现高凝倾向。噻氯匹定治疗能明显缓解血栓前状态。PAC 1的表达可作为GPⅡb Ⅲa激活更敏感的新型特异性标志
Objective: To further clarify the platelet activation in patients with diabetes (DM) and the anti-platelet drug ticlopidine treatment. Methods: Flow cytometry was used to detect platelet membrane glycoprotein (GP) Ⅰb, GPⅡb, P-selectin and platelet activating complex 1 (GPR) on platelet surface in 45 patients with type 2 diabetes mellitus and 26 healthy volunteers PAC 1), and 20 cases of type 2 DM patients treated with ticlopidine (0 2 5g, qd) 2wk, observed the impact of these indicators. Results: The fluorescence intensity of P-selectin and PAC-1 expression in DM patients was significantly higher than that in control group, while the fluorescence intensity of GPIb was lower than that in control group (P = 0 0 14) and GPⅡb expression (P = 0 2 85). Ticlopidine treatment 2wk DM patients with P-selectin and PAC 1 expression decreased significantly, the expression of GP Ⅱ b had no significant effect (P = 0 815), GP Ⅰ b expression increased (P = 0.01). Conclusion: The platelet activation in Type 2 DM patients is enhanced and the tendency of hypercoagulability appears. Ticlopidine treatment can significantly relieve the prethrombosis state. PAC 1 expression can be used as GPⅡb Ⅲa activation more sensitive new type of specific markers