Ⅱ型糖尿病における血漿中組織plasminogen activatorとplasminogen activator inhibitor

Tissue plasminogen activator and its inhibitor in type two diabetes mellitus

　Ⅱ型糖尿病患者36名，を網膜症のない群，単純型網膜症群，増殖型網膜症群の3群に分類し血漿中組織plasminogen activator（tPA），plas-minogen activator inhibitor-1（PAI-1；PAI-total，PAI-complex，PAI-free），plasminogenactivator活性（PAA）について正常ボランティア21名と比較検討した。tPA，PAI-total，PAI-complex，PAI-free各濃度は単純型網膜症群で他群と比較し上昇していた。PAAは網膜症のない群で若干高い傾向が認められたが有意の差はなかった。Ⅱ型糖尿病性細小血管症の初期には血管内皮細胞からtPA，PAI-1分泌が亢進しているが，PAI-1による糸泉溶抑制が優位な状態にあると考えられた。インスリン治療の有無でtPA，PAI-1，PAAに有意の差はみられなかった。

We quantitated the plasma levels of tissue plas-minogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1) and plasminogen activator activity (PAA) in 36 patients with type 2 diabetes mellitus. We used enzyme immunoassay in the quantitation. The series included 14 patients with-out retinopathy, 12 with simple retinopathy and 10 with proliferative retinopathy. A group of 21 nor-mal subjects served as control. PAI-1 wasquantitated as to PAI-total, PAI-complex and PAI -free components.

The group with simple retinopathy showed higher values for tPA, PAI-total, PAI-complex and PAI-free concentrations. There was no significant changes in PAA among the different groups. There was no difference in fibrinolytic activity between patients under insulin and under dietary or oral hypoglycemic therapy. The findings were sugges-tive of suppressed fibrinolytic activity during the early stage of diabetic microangiopathy.