2型糖尿病患者血清炎症因子水平的变化及对心脑血管病变的影响

目的观察2型糖尿病患者血清炎症因子水平的变化，探讨炎症因子对2型糖尿病尤其老年患者合并心脑血管病变的影响。方法103例2型糖尿病患者按年龄及是否合并心脑血管病变进行分组。用自动生化分析仪测定所有患者血清超敏C反应蛋白（Hs-CRP）、空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯（TG）、低密度脂蛋白-胆固醇水平，用ELISA方法测定血清白介素-6（IL-6）和肿瘤坏死因子-a（TNF-Q）水平。结果（1）2型糖尿病患者年龄≥65岁者，血清Hs-CRP、TNF-q、IL-6水平均高于年龄〈65岁者（P=0．003，P=0．001，P=0．007）。（2）合并心脑血管病变者，血清Hs-CRP水平高于无心脑血管病变者（P=0．015）。且年龄≥65岁合并心脑血管病变者，血清Hs-CRP水平高于无心脑血管病变者（P=0．040）。（3）血清Hs-CRP水平与年龄和血清TG水平呈正相关（r=0．257，P=0．000；rE0．220，P=0．003）。影响Hs-CRP的因素主要为年龄，回归方程为Y（Hs-CRP）=2．407＋0．100X（年龄）。（4）2型糖尿病中年龄≥65岁者合并心脑血管病变的发生率高于年龄〈65岁者（P=0．000）。结论炎症因子CRP、TNF-a、IL-6与老年2型糖尿病合并心脑血管病变密切相关；增龄是血清Hs-CRP水平升高的主要影响因素。

Effect of serum inflammatory factors on cardiocerebral vascular disease in patients with type 2 diabetes mellitus

Objective To investigate the effect of the serum inflammatory factor on type 2 diabetes mellitus （T2DM） especially among elderly patients complicated with cardiocerebral vascular disease. Methods We studied 103 T2DM patients, and divided them into groups according to the age and whether complicated with cardiocerebral vascular disease or not. The levels of serum high sensitivity C-reactive protein（Hs-CRP）, fasting blood glucose, glycosylated hemoglobin, cholesterol total, triglyceride（TG）, and low density lipoprotein~eholesterol were detected with automatic biochemistry analyzer and serum tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6） with ELISA in all patients. Results （1）Among them, the levels of serum Hs-CRP,TNF-α and IL-6 in patients of age≥65 years old were higher than those of age〈65 years old （P=0. 003,P=0. 001 ,P= 0. 007, respectively）. （2）The level of serum Hs-CRP in patients with T2DM complicated with eardiocerebral vascular disease was higher than those without it（P= 0. 015）. And in patients of age 65 years old, the level of serum Hs-CRP in patients complicated with cardioeerebral vascular disease was higher than that in the those without it（P=0. 040）. （3）The level of serum Hs-CRP was positively correlated with age and the level of serum TG（r=0. 257,P=0. 000;r=O. 220,P=0. 003）. The impact factor on Hs-CRP was age, the regression equation was Y（Hs-CRP）= 2. 407＋0. 100X（age）. （4）The incidence of cardiocerebral vascular disease in T2DM patients of age≥65 years old was higher than that in the patients of age≥65 years old（P=0. 000）. Conclusion Inflammatory factors such as CRP,TNF-α and IL-6 are correlated with elderly T2DM patients complicated with cardiocerebral vascular disease; and age is a main impact factor on Hs-CRP.