糖尿病视网膜病变患者外周血中性粒细胞表面CD18的表达

目的研究不同程度糖尿病视网膜病变（DR）患者外周血中性粒细胞表面CD18的表达。方法38例DR患者，其中包括1期DR组10例，2～4期DR组14例，5期DR组14例。正常对照组10例。流式细胞仪测量受试者外周血中性粒细胞表面CD18的表达。结果4个组CD18平均荧光强度（MCF）之间的差异有统计学意义（P〈0．01）。CD18的表达水平最高为5期DR组，其次为2-4期DR组及1期DR组，最低为正常对照组（趋势检验，P〈0．01）。调整混杂因素后这种趋势仍然存在。多元线性回归分析显示CD18的MCF水平与DR分期存在显著相关性（β＝0．33，P=0．01）。结论外周血中性粒细胞表面CD18水平的提高可能是2型糖尿病患者DR进展的临床标志。

Expression of CD18 on the neutrophils of patients with diabetic retinopathy

Objective Diabetic retinopathy （DR） is a severe complication of diabetes. Experimental study demonstrated that CD18 plays an important role in the development of DR. But the relationship between DR severity and CD18 expression is unclear. This study was to investigate the expression of CD18 on the neutrophils in patients with various stages of DR and determine the relationship between CD18 and development of DR. Methods Level of CD18 on neutrophils was measured by flow cytometry in 10 patients with the DR of stage 1,14 patients with DR of stages 2 -4,14 patients with DR of stage 5 and 10 non-diabetic healthy subjects （control）. Results No significant differences were found in the age and gender among the subjects of 4 groups （ P 〉 0.05 ）. Mean channel fluorescence （MCF） of CD18 on neutrophils from the control, stage 1 , stages 2 - 4 and stage 5 of DR patients was 1.36±0. 17,2.99± 1.44,3. 13±1. 10 and 4. 11± 1.62 respectively,with the highest MCF level in the stage 5 of DR group and the least MCF level in the control group, showing a significant difference among them （P 〈 0.01 ）. This trend remained even after adjusting for confounding variables. The statistical analysis indicated that this trend was only significant in type 2 diabetic patients. Multiple linear regression against the level of CD18 MCF by stage of DR and covariates revealed a significant and independent correlation with the stage of DR （β = 0. 33, P = 0. 01 ）. Conclusion CD18 is overexpressed on neutrophils in each stage of DR in type 2 diabetic patients. The expression level of CD18 is positive associated with stage of DR. CD18 may be a marker of the development of DR in type 2 diabetes.