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目的观察Ⅱ型糖尿病患者血小板膜糖蛋白的变化及其临床意义。方法应用流式细胞术（ＦＣＭ）观察７０例Ⅱ型糖尿病患者及２８名正常人血小板膜上ＧＰⅠｂ、Ⅱｂ、Ⅲａ及Ｐ选择素的表达。以免疫放射法（ＩＲＭＡ）测定血小板膜Ｐ选择素分子数，并以酶联免疫法（ＥＬＩＳＡ）对血浆中的Ｐ选择素进行检测。结果ＦＣＭ测得的血小板膜上Ｐ选择素表达阳性率，糖尿病伴血管病患者为（１０．２８±４．８６）％，明显高于正常人的（３．７５±１．８３）％（Ｐ＜０．０１）及无血管病变者的（４．２５±２．２９）％（Ｐ＜００１）。用ＩＲＭＡ法测得的结果与ＦＣＭ类似。血浆中Ｐ选择素浓度伴血管病变组（６．１８±３．２０）μｇ／Ｌ亦高于正常对照组的（３．４３±１．５６）μｇ／Ｌ（Ｐ＜０．０５）及无血管病变组的（３．７１±２．１２）μｇ／Ｌ（Ｐ＜００５）。相反，血小板上ＧＰⅠｂ的表达在糖尿病伴血管病变组为（８６．３５±１１．００）％明显低于正常对照组的（９２６３±７．５５）％（Ｐ＜０．０５）。而血小板ＧＰⅡｂ、Ⅲａ的表达无改变。结论有血管病变的Ⅱ型糖尿患者血小板膜上和血浆中Ｐ选择素升高，而ＧＰⅠｂ降低。
Objective To investigate the changes of platelet membrane glycoprotein in type 2 diabetic patients and its clinical significance. Methods Flow cytometry (FCM) was used to observe the expression of GPⅠb, Ⅱb, Ⅲa and Pselectin in 70 patients with type Ⅱ diabetes mellitus and 28 normal persons. P-selectin was detected by immunoradiometric assay (IRMA), and P-selectin in plasma was detected by enzyme-linked immunosorbent assay (ELISA). Results The positive rate of P-selectin expression in platelet membrane measured by FCM was (10.28 ± 4.86)% in diabetic patients with vascular disease, which was significantly higher than that in healthy people (3.75 ± 1.83)% ( P <0.01) and those with no vascular lesions (4.25 ± 2.29)% (P <001). The results measured by the IRMA method are similar to those of the FCM. Plasma concentrations of P-selectin and vascular lesions (6.18 ± 3.20) μg / L were also significantly higher than those in normal controls (3.43 ± 1.56 μg / L, P <0.05) and (3.71 ± 2.12) μg / L in non-vascular group (P <005). In contrast, GPIb expression on platelets was significantly lower in diabetic patients with vascular lesions (86.35 ± 11.00% vs 92.63 ± 7.55%, P <0.05). The platelet GP Ⅱ b, Ⅲ a expression of no change. Conclusions Patients with type II diabetes mellitus with vascular disease have elevated P-selectin and GPIb on platelet membrane and plasma.