Omoto S, Nomura S, Shouzu A, Hayakawa T, Shimizu H, Miyake Y, Yonemoto T, Nishikawa M, Fukuhara S, Inada M
Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Nephron. 1999;81(3):271-7. doi: 10.1159/000045292.
We measured levels of platelet-derived microparticles (PMP), which have coagulative activity and are produced by platelet activation or physical stimulation, and CD62P/CD63-positive platelets in patients with diabetes mellitus to determine their clinical significance and effects on complications of diabetes including diabetic nephropathy. We also compared these levels before and after administration of the antiplatelet drug cilostazol. Plasma PMP and CD62P/CD63-positive platelet levels were significantly higher in patients with diabetes mellitus than normal controls. CD62P-positive platelet levels were significantly higher in patients with nephropathy than in patients without complications. After administration of cilostazol, PMP and CD62P/CD63-positive platelet levels were significantly decreased. The increases in platelet activity and its related procoagulant activity appear to account in part for the hypercoagulability observed in diabetes mellitus. Our findings suggest that activated platelets might play a role in the development of diabetic nephropathy. Furthermore, antiplatelet therapy with cilostazol for diabetic patients may be useful as antithrombin therapy including antiplatelet therapy, since it suppresses the production of intrinsic coagulants produced by platelet activation.
我们检测了糖尿病患者血小板衍生微粒（PMP）和CD62P/CD63阳性血小板的水平，PMP具有凝血活性，由血小板激活或物理刺激产生，检测目的是确定它们的临床意义以及对糖尿病并发症（包括糖尿病肾病）的影响。我们还比较了抗血小板药物西洛他唑给药前后这些水平的变化。糖尿病患者血浆PMP和CD62P/CD63阳性血小板水平显著高于正常对照组。肾病患者CD62P阳性血小板水平显著高于无并发症患者。给予西洛他唑后，PMP和CD62P/CD63阳性血小板水平显著降低。血小板活性及其相关促凝活性的增加似乎部分解释了糖尿病中观察到的高凝状态。我们的研究结果表明，活化血小板可能在糖尿病肾病的发生发展中起作用。此外，对糖尿病患者采用西洛他唑进行抗血小板治疗可能作为包括抗血小板治疗在内的抗凝血酶治疗是有用的，因为它抑制了血小板激活产生的内源性凝血因子的产生。
