The Study Of Correlation Between The Drug Treatment And Theconcentration Dynamic Change Of Von Willebrand Factor Concentration (vWF) In The Plasma Of Type2Diabetes With Cerebral Infarction Patients

Objective: Diabetes has become a serious disease threatting people'shealth, and has taken a heavy economic burde to society and the family.Therefore, the prevention and cure of diabetes have become the focus ofhealth problems. With the further study in pathogenesis of diabetes, theimportant role of endothelial cell damage has been paid more attention in thedevelopment of diabetes and its vascular complications. Von Willebrand factor(vWF) is considered to be one of the markers of vascular endothelial cellinjury. vWF is a macromolecular adhesion proteins which is synthesized andsecreted by endothelial cells, megakaryocytes and platelet granule. And theendothelial cells are most important functional cells for the synthesis andsecretion of vWF. vWF has two major biological functions:(1) Mediatingplatelet adhesion, aggregation and thrombus formation in vascular injury;(2)bining with preFVIII to form VIII/vWFcomplex, which plays the role on a Ⅷfactor carrier in the blood circulation.Through testing plasma vWF concentration of patients who suffered type2diabetes with cerebral infarction, observing the dynamic changes of theconcentration of vWF of these patients, studying the relationship betweenvWF and disease development of type2diabetes and combined with cerebralinfarction, investigating the damaged mechanism of rised vWF concentrationfor type2diabetes and combined with cerebral infarction, this experiment is toprovide experimental basis for the prevention and clinical treatment of type2diabetes and combined with cerebral infarction.Methods:60patients of type2diabetes and60patients of type2diabetes with cerebral infarction were selected from the inpatient in endocrinology,30healthy persons were selected from the medicalexamination center as normal controls.60patients of type2diabetes wasgroup A (Randomly selected30patients for group A₁, the remaining30patients for group A₂). Respectively, elbow venous blood was collected in thefasting morning of2days and14days after hospitalization, put it aside, aftercentrifugated, the upper plasma was to test the concentration of vWF.60patients of type2diabetes with cerebral infarction was group B (Randomlyselected30patients for group B₁, the remaining30patients for groupB₂).Respectively, elbow venous blood was collected in the fasting morning of2days,7days and14days after hospitalization, put it aside, after centrifugated,the upper plasma was to test the concentration of vWF.30cases of normalcontrol were collected venous blood in the fasting morning on the same day ofexamination, put it aside, after centrifugation, the upper plasma was to test theconcentration of vWF.60patients of type2diabetes and60patients of type2diabetes with cerebral infarction were collected venous blood in the fastingmorning of2days after hospitalization, which was to determine glycosylatedhemoglobin(HbA1c). Normal controls was collected venous blood in thefasting morning on the examine day to determine HbA1c. By SPSS13.0statistical analysis software to analysis of plasma concentration of vWF andHbA1c, all measurement data was expressed by mean±standard deviation.Among three groups were compared by single factor analysis of variance,mean of two groups were compared by t-test. P<0.05was considered to bestatistically significant difference.Result:1There is no significant differences in age, gender, in all selected subjects.2Before the treatment Plasma concentration of vWF of normal controlgroup is31.48±3.15U/L, HbA1c is (5.31±0.52)%, that of group A is64.72±7.92U/L, HbA1c is (7.36±1.25)%, which of group B is122.33±8.12U/L, HbA1c is (8.34±1.43)%. vWF concentration and HbA1cgradually increased among the three groups, the differences between the threepairwise comparisons are statistically significant (P<0.05). Plasma concentration of vWF of group A₁is63.06±7.21U/L, that of group A-2is66.38±8.35U/L, that of group B₁is121.44±9.12U/L, which of group B₂is123.22±7.03U/L. There is no significant difference about plasmaconcentration of vWF between group A₁and group A₂, and there is nosignificant difference about plasma concentration of vWF between group B₁and group B₂.3During the treatment Concentration of vWF of group B₁on7days is110.92±7.76U/L, that of group B₂on7days is100.30±3.35U/L, which issignificantly different between the two (P<0.05).4After the treatment Plasma concentration of vWF of group A₁on14days is61.12±7.44U/L, that of group A₂on14days is43.19±6.58U/L. Plasmaconcentration of vWF in group B-1on14days is93.08±7.20U/L, that of groupB₂on14days is80.11±4.62U/L. There is significant difference betweengroup A₁and group A₂(P<0.05), there is significant difference betweengroup B₁and group B₂(P<0.05).Conclusion: The results suggest that plasma concentration of vWF inpatients who suffered type2diabetes and combined with cerebral infarctionare higher than control group, the difference is statistically significant. Theplasma concentration of vWF significantly decreased after drug treatmentcompared with that before the treatment and there are significant differencesbetween two data. Elevated plasma concentration of vWF in type2diabetesand combined with cerebral infarction patients are caused by endothelialinjury and endothelial dysfunction, which subsequently induced excessivevWF secretion by endothelial cells. So the increase of vWF may reflectendothelial injury in type2diabetes patient and predict incidence of cerebralinfarction, and provide evidence for the prevention and clinical treatment oftype2diabetes with cerebral infarction.