Collier A, Tymkewycz P M, Matthews D M, Jones R L, Clarke B F
Diabetic Department, Royal Infirmary, Edinburgh, UK.
Diabetes Res. 1987 Jun;5(2):79-82.
Numerous platelet abnormalities, particularly hyperaggregation, have been described in diabetic patients, and it has been suggested that these may contribute towards the pathogenesis of microvascular complications. In the present study, the changes that occur in ADP-induced aggregation, sensitivity to a stable prostacyclin analogue (Iloprost), aggregation-induced thromboxane B2 production and platelet cyclic AMP levels were investigated in 9 young insulin-dependent diabetics, in which the glycaemic control significantly improved in one group (n = 5; HbA1 from 11.9-9.0%) over a 6 month period. With improvement of glycaemic control there was no significant change in the concentration of ADP required to produce 50 percent of the maximum aggregation wave response. However, there was a significant increase in the responsiveness of platelets to Iloprost and increased platelet thromboxane B2 production. There was no significant difference between the basal platelet cAMP levels before or after exposure to Iloprost. This study suggests that with improved short-term glycaemic control, although there are changes in platelet function, there may be no alteration in the homeostatic balance.
众多血小板异常情况，尤其是血小板过度聚集，在糖尿病患者中已有描述，并且有人提出这些异常情况可能促成微血管并发症的发病机制。在本研究中，对9名年轻的胰岛素依赖型糖尿病患者进行了研究，观察了二磷酸腺苷（ADP）诱导的聚集、对稳定的前列环素类似物（伊洛前列素）的敏感性、聚集诱导的血栓素B2生成以及血小板环磷酸腺苷（cAMP）水平的变化。其中一组（n = 5；糖化血红蛋白从11.9%降至9.0%）在6个月期间血糖控制显著改善。随着血糖控制的改善，产生最大聚集波反应50%所需的ADP浓度没有显著变化。然而，血小板对伊洛前列素的反应性显著增加，且血小板血栓素B2生成增加。暴露于伊洛前列素前后的基础血小板cAMP水平没有显著差异。本研究表明，短期血糖控制改善后，尽管血小板功能发生了变化，但体内平衡可能并未改变。
