糖尿病網膜症患者の血清トロンボモジュリンと血清Ⅲ型プロコラーゲンペプタイドの変動

Changes in plasma thrombomodulin and type Ⅲ procollagen peptide levels in diabetic patients with retinopathy

　糖尿病患者66例について全身の血管内皮細胞障害の指標とされる血清トロンボモジュリン値（TM）と，血清Ⅲ型プロコラーゲンペプタイド値（P—Ⅲ—P）を測定し，糖尿病網膜症の進展を予測できるかを検討した。TM, P—Ⅲ—Pは対照群（3.31±0.56ng／dl,0.51±0.12ng／dl）と比べ単純性糖尿病網膜症群（3.98±1.98ng／dl,0.648±0.33ng／dl）が，さらに増殖性糖尿病網膜症群（4.83±294ng／dl, 0.72±0.35ng／dlが有意に高値であった。糖尿病網膜症の病期では，TMでは対照群（3.31±0.56ng／dDと比べ単純性糖尿病網膜症2（4.31±1.98ng／dD，単純性糖尿病網膜症3（3.86±0.51ng／dl，増殖性糖尿病網膜症1（5.75±2.79ng／dD期が，P—Ⅲ—Pでは対照群（0.51±0.12ng／dDと比べ単純性糖尿病網膜症2（0.67±0.28ng／dl），増殖性糖尿病網膜症1（0.82±0.44ng／dl）期で有意に高値となった。細小血管の内皮障害は前増殖性網膜症の段階で最大となり，TMおよびP—Ⅲ—Pが，糖尿病網膜症の悪化を示す指標となるのではないかと考えた。

We quantitated the plasma levels of thrombomodulin (TM) and type Ⅲ procollagen peptide (P-Ⅲ-P) in 66 diabetic patients. Both values were significantly higher in the patients than in normal controls (TM: 3.31±0.56 ng/dl, P-Ⅲ-P: 0.51±0.12ng/dl). Both values were higher in patients with proliferative dialetic retinopathy (PDR) than in those with simple retinopathy (SDR). The mean levels of TM were higher in patients with stage 1 and 2 SDR and stage 1 PDR than in controls. The mean levels of P-III-P were higher in stage 2 SDR and stage 1 PDR than in contols. TM and P-Ⅲ-P levels could serve as useful markers for progression of PDR.