Monnier L H, Rodier M, Gancel A, Crastes de Paulet P, Colette C, Piperno M, Crastes de Paulet J
Diabete Metab. 1987 Jun;13(3):210-6.
Eleven insulin-dependent diabetics exhibiting a fair but less than ideal diabetic control (HbA1 = 10.0 +/- 0.6%) were submitted in a random order to two 6 week-study periods of: continuous subcutaneous insulin infusion (CSII) and optimized conventional insulin therapy. Plasma lipids, fatty acids in plasma lipids and platelet function were estimated at baseline and at the end of each study period. Declines in HbA1 were observed at the end of either CSII or conventional period compared with baseline, but the differences were only significant under CSII (P less than 0.02). Plasma lipids and apoproteins remained unchanged at the end of the two study periods compared with baseline. Both CSII and optimized conventional treatment were followed by a significant increase of arachidonate in plasma lipids. A deterioration of the platelet function estimated from ADP or epinephrine-induced platelet aggregation and TxB2 generation by platelets was found under optimized conventional treatment while the platelet function appears to be normal at baseline and under CSII. These data indicate that slight but not sufficient improvements of diabetic control can result in deterioration of the platelet function. It seems that these deleterious effects are mediated through an increased production of arachidonate and in turn of TxB2.
11名胰岛素依赖型糖尿病患者，其糖尿病控制情况尚可但未达理想水平（糖化血红蛋白HbA1 = 10.0 +/- 0.6%），被随机安排接受两个为期6周的研究阶段，分别为持续皮下胰岛素输注（CSII）和优化的传统胰岛素治疗。在基线期以及每个研究阶段结束时评估血脂、血脂中的脂肪酸以及血小板功能。与基线期相比，在CSII期或传统治疗期结束时均观察到HbA1下降，但差异仅在CSII期显著（P < 0.02）。与基线期相比，在两个研究阶段结束时血脂和载脂蛋白均保持不变。CSII和优化的传统治疗后血脂中的花生四烯酸均显著增加。在优化的传统治疗下，由二磷酸腺苷（ADP）或肾上腺素诱导的血小板聚集以及血小板生成血栓素B2（TxB2）所评估的血小板功能恶化，而在基线期和CSII期血小板功能似乎正常。这些数据表明，糖尿病控制的轻微但不充分改善可导致血小板功能恶化。似乎这些有害作用是通过花生四烯酸产量增加进而血栓素B2产量增加介导的。
