糖尿病患者血细胞体积增大在微血管病变中的作用

摘要

目的探讨糖尿病患者血细胞体积增大的原因及在微血管病变中的作用。方法52例糖尿病患者部分血细胞参数和红细胞膜Na+-K+-ATPase、Ca2+-ATPase活性分别采用全自动血细胞分析仪和改良的Hanahan法、Luthra法测定，并设对照组比较。结果糖尿病患者红细胞膜Na+-K+ATPase、Ca2+-ATPase活性降低，以合并微血管病变组最为明显；微血管病变组平均红细胞体积(MCV)、平均血小板体积(MPV)增大，平均红细胞血红蛋白浓度(MCHC)降低；而无微血管病变组则正常。MCV、MCHC和MPV的变化与红细胞膜两种ATPase活性降低有关。结论与ATPase活性改变有关的血细胞体积增大可能是糖尿病微血管病变发生的重要因素。%Objective To investigate the cause of increased blood cell volume and its action on microangiopathy in diabetic patients. Methods Some parameters of blood cell and Na+-K+-ATPase and Ca2+-ATPase activities in erythrocyte membrane were determined by automatic blood cell analyzer, modified Hanahan's, and Luthra's methods in 52 diabetic patients and 49 normal controls. Results Activities of Na+-K+-ATPase and Ca2+-ATPase in erythrocyte membrane were decreased in the diabetic patients, especially those with microangiopathy. Mean corpuscular volume (MCV) and mean platelet volume (MPV) increased and mean corpuscular haemoglobin concentration (MCHC)decreased in the patients with microangiopathy. Whereas they were normal in those without microangiopathy. The changes of MCV, MPV and MCHC were related to the decrease in both ATPase activities in erythrocyte membrane.Conclusion The increase in blood cell volume relevant to the decrease in ATPase activities were probably important factors in the pathogenesis of diabetic microangiopathy.