Jensen T, Bjerre-Knudsen J, Feldt-Rasmussen B, Deckert T
Steno Memorial Hospital, Gentofte, Denmark.
Lancet. 1989 Mar 4;1(8636):461-3. doi: 10.1016/s0140-6736(89)91365-2.
The release of tissue plasminogen activator (tPA) by vascular endothelial cells during exercise was studied in forty men with insulin-dependent diabetes. Three groups, matched for age and diabetes duration, were defined as: group I (n = 19), normal urinary albumin excretion (less than 30 mg/24 h); group II (n = 11), incipient diabetic nephropathy (30-300 mg albumin excreted per 24 h); and group III (n = 10), clinical diabetic nephropathy (more than 300 mg albumin excreted per 24 h). Nine non-diabetic men served as controls. The rise in tPA antigen with exercise was similar in the controls and group I but significantly smaller in groups II and III (p less than 0.01). The albumin transcapillary escape rate was significantly higher in groups II and III than in group I and normal controls (p less than 0.01). The basal plasma level of von Willebrand factor was higher in groups III (p less than 0.01) and II (difference not significant, p = 0.06) than in group I and normal controls. These findings suggest that insulin-dependent diabetic patients with only slightly raised urinary albumin excretion have general endothelial cell dysfunction or damage. It is not yet clear whether these changes are important in the pathogenesis of thrombosis and atherosclerosis in these patients.
在40名胰岛素依赖型糖尿病男性患者中，研究了运动期间血管内皮细胞组织纤溶酶原激活物（tPA）的释放情况。根据年龄和糖尿病病程匹配，将患者分为三组：第一组（n = 19），尿白蛋白排泄正常（<30 mg/24 h）；第二组（n = 11），早期糖尿病肾病（每24小时排泄白蛋白30 - 300 mg）；第三组（n = 10），临床糖尿病肾病（每24小时排泄白蛋白>300 mg）。9名非糖尿病男性作为对照。运动后对照组和第一组tPA抗原升高情况相似，但第二组和第三组显著较小（p<0.01）。第二组和第三组的白蛋白跨毛细血管逃逸率显著高于第一组和正常对照组（p<0.01）。第三组（p<0.01）和第二组（差异不显著，p = 0.06）的血管性血友病因子基础血浆水平高于第一组和正常对照组。这些发现表明，尿白蛋白排泄仅略有升高的胰岛素依赖型糖尿病患者存在一般内皮细胞功能障碍或损伤。目前尚不清楚这些变化在这些患者血栓形成和动脉粥样硬化发病机制中是否重要。
