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目的 探讨２型糖尿病（２－ＤＭ）患者血浆可溶性内皮细胞蛋白Ｃ受体（ｓＥＰＣＲ）和血栓调节蛋白（ｓＴＭ）的变化及其临床意义。方法 采用酶联免疫双抗体夹心法测定７４例２－ＤＭ患者和２９例正常对照组（Ｋ组）ｓＥＰＣＲ和ｓＴＭ，并根据２４ｈ尿白蛋白（２４ｈＵＡＥ）分为 Ａ组（ｎ＝３６，２４ｈＵＡＥ＜３０ｍｇ）、Ｂ组（ｎ＝２４，２４ｈＵＡＥ３０～３００ ｍｇ）和 Ｃ组（ｎ＝１４，２４ｈＵＡＥ≥３００ｍｇ）。结果 与Ｋ组比较，ＤＭ患者血浆ｓＥＰＣＲ和ｓＴＭ显著升高，Ｐ＜０．０５和Ｐ＜０．０１；分组比较，Ａ组ｓＥＰＣＲ和ｓＴＭ水平无显著差异，Ｂ组显著升高（Ｐ＜０．０５和＜０．０１），Ｃ组更进一步升高，Ｐ值分别小于 ０．０１和 ０．００１；ｓＥＰＣＲ与ｓＴＭ、２４ｈＵＡＥ和糖化血红蛋白呈显著正相关（Ｐ＜０．０５），ｓＴＭ与２４ｈＵＡＥ（Ｐ＜０ ．０１）和糖化血红蛋白（Ｐ＜０．０５）呈显著正相关；ｓＥＰＣＲ和ｓＴＭ与ＤＭ病程、空腹血糖、血脂和年龄均无相关性。结论ＳＥＰＣＲ和ｓＴＭ升高与ＤＭ血管病变的发生和严重程度相关，是反映血管内皮细胞功能的良好指标，并可能参与其高凝状态的形成。
Objective To investigate the changes of plasma soluble endothelial protein C receptor (sEPCR) and thrombomodulin (sTM) in patients with type 2 diabetes mellitus (DM) and its clinical significance. Methods Serum levels of sEPCR and sTM were measured in 74 cases of 2-DM patients and 29 cases of normal control group (K group) by enzyme-linked immunosorbent assay (ELISA), and divided into group A (n = 36,24 hUAE < 30mg), group B (n = 24, 24hUAE30 ~ 300mg) and group C (n = 14,24hUAE≥300mg). Results Compared with group K, the plasma levels of sEPCR and sTM were significantly increased in DM patients (P <0.05 and P <0.01). There was no significant difference in sEPCR and sTM between group A and group B .05 and <0.01), C group was further increased, P values were less than 0.01 and 0.001 respectively; sEPCR and sTM, 24hUAE and glycosylated hemoglobin were significantly correlated (P <0.05), sTM and There was a significant positive correlation between 24hUAE (P <0.01) and glycosylated hemoglobin (P <0.05). There was no correlation between sEPCR and sTM and DM course, fasting blood glucose, blood lipid and age. Conclusions The elevated SEPCR and sTM correlate with the occurrence and severity of vascular dementia and are good indicators of vascular endothelial function and may be involved in the formation of hypercoagulable state.