Telejko Beata, Tomasiak Marian, Stelmach Halina, Kinalska Ida
Klinika Endokrynologii, Diabetologii i Chorób Wewnetrznych AM w Białymstoku.
Pol Arch Med Wewn. 2002 Jun;107(6):533-7.
Platelet sodium-proton exchange rate and phospholipid dependent procoagulant activity were measured in 31 type 1 diabetics (mean age 32.3 +/- 10.1 years) and 35 healthy subjects (mean age 35.4 +/- 9.4 years). The activity of platelet Na+/H+ exchanger was measured in platelet rich plasma, using an optical swelling assay, according to Rosskopf et al. Platelet procoagulant activity was measured in platelet rich plasma, platelet poor plasma and platelet/microparticles filtrated plasma, using Russell's viper venom (according to Jy and Horstman) and calibrated with ship L-alpha-phosphatidylethanolamine. We found that Na+/H+ exchange rate was significantly higher in diabetic patients in comparison to the controls (p = 0.0009). There was also a positive correlation between the activity of Na+/H+ exchanger and phospholipid dependent procoagulant activity in all plasma fractions. We did not find a significant association between Na+/H+ exchanger activity and metabolic parameters studied, however in patients with HbA1c level > 7.5% higher Na+/H+ exchange rates were noted. Total procoagulant activity did not rise significantly in diabetic patients, but was markedly higher in platelet poor and platelet filtrated plasma. It was supposed that it originated from platelet derived microparticles, enriched in phospholipids. Our results suggest that an increased platelet Na+/H+ exchange rate and raised procoagulant activity connected with platelet microparticles may enhance the risk of vascular damage in type 1 diabetic patients.
对31名1型糖尿病患者（平均年龄32.3±10.1岁）和35名健康受试者（平均年龄35.4±9.4岁）测量了血小板钠-质子交换率和磷脂依赖性促凝血活性。根据罗斯科普夫等人的方法，采用光学肿胀试验在富含血小板的血浆中测量血小板Na⁺/H⁺交换器的活性。使用罗素蝰蛇毒（根据Jy和霍斯特曼的方法）并以船用L-α-磷脂酰乙醇胺校准，在富含血小板的血浆、血小板缺乏血浆和血小板/微粒过滤血浆中测量血小板促凝血活性。我们发现，与对照组相比，糖尿病患者的Na⁺/H⁺交换率显著更高（p = 0.0009）。在所有血浆组分中，Na⁺/H⁺交换器的活性与磷脂依赖性促凝血活性之间也存在正相关。我们未发现Na⁺/H⁺交换器活性与所研究的代谢参数之间存在显著关联，然而，在糖化血红蛋白水平>7.5%的患者中，观察到Na⁺/H⁺交换率更高。糖尿病患者的总促凝血活性没有显著升高，但在血小板缺乏和血小板过滤血浆中明显更高。推测其源自富含磷脂的血小板衍生微粒。我们的结果表明，血小板Na⁺/H⁺交换率增加以及与血小板微粒相关的促凝血活性升高可能会增加1型糖尿病患者血管损伤的风险。
