血清黏附分子和细胞因子与2型糖尿病患者血管病变的关系

目的 探讨2型糖尿病（T2DM）患者血清黏附分子与细胞因子水平以及与血管病变的关系.方法 选择96例T2DM患者按照血管病变情况分为无血管病变组（28例）、微血管病变组（33例）、大血管病变组（35例）,选择同期健康体检者30名作为对照组,ELISA法检测血清细胞间黏附分子1（ICAM-1）和血管细胞黏附分子1（VCAM-1）,细胞因子包括白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）和假性血友病因子（vWF）浓度,同时检测治疗半个月后T2DM患者黏附分子和细胞因子的表达.结果 与对照组比较,T2DM患者不同血管病变组ICAM-1、VCAM-1、IL-6和TNF-α水平都明显增高,差异有统计学意义（P均＜0.05）,且随着患者血管病变的严重,其表达也有升高趋势,差异有统计学意义（P均＜0.05）;治疗半个月后,患者血清ICAM-1、VCAM-1、IL-6和TNF-α水平显著性降低,差异具有统计学意义（t值分别为16.281、8.712、7.697、8.445,P均＜0.05）,各指标分别从治疗前（505.34±56.42） μg/L,（570.85±59.54）μg/L,（94.51±18.04） ng/L,（70.57±18.34） ng/L降到治疗后（390.53±45.23） μg/L,（482.93±69.85） μg/L,（77.31±15.49） ng/L,（50.45±12.66） ng/L;T2DM患者血清ICAM-1、VCAM-1、IL-6及TNF-α水平与vWF的表达都呈明显的正相关（r值分别为0.482、0.453、0.576、0.534,P均＜0.05）.结论 黏附分子和细胞因子共同参与了T2DM恶化以及血管病变的发生发展.

The relationship of adhesion molecules,cytokines and vascular disease in patients with type 2 diabetes

Objective To explore the relationship of the levels of adhesion molecules and cytokines with vascular disease in patients with type 2 diabetes （T2DM）.Methods Ninety-six T2DM patients were selected as case group and divided into non-vascular group （28 cases）,micro-vascular group （33 cases） and major vascular group（35 cases） according to vascular disease.Meanwhile,30 healthy persons were selected as control group.Serum levels of serum soluble intercellular adhesion molecule-1 （ICAM-1）,vascular cell adhesion molecule-1 （VCAM-1）,interleukin-6 （IL-6）,tumor necrosis factor-α （TNF-α） and yon willebrand factor （vWF） were determined by Enzyme-Linked Immuno Sorbent Assay （ELISA）,and the expression of adhesion molecule and cytokines of patients with T2MD at 2 weeks after treatment.Results Compared with control group,the levels of ICAM-1,VCAM-1,TNF-α and IL-6 in all subgroup of T2DM patients were significantly elevated（P 〈 0.05）,and the levels showed an increasing trend with function deterioration （P 〈 0.05）.The levels of ICAM-1,VCAM-1,IL-6 and TNF-α in case group before treatment were （505.34 ± 56.42） μg/L,（570.85 ±59.54） μg/L,（94.51 ± 18.04） ng/L,（70.57 ± 18.34） ng/L respectively,significant different from those of after treatment （（390.53 ±45.23） μg/L,（482.93 ± 69.85） μg/L,（77.31 ± 15.49） ng/L,（50.45 ± 12.66） ng/L; t =16.281,8.712,7.697,8.445; P 〈 0.05）.There were significant positive correlation between ICAM-1,VCAM-1,IL-6,TNF-α and vWF in the case group（r =0.482,0.453,0.576,0.534 respectively,P 〈 0.05）.Conclusion Adhesion molecules and cytokines are take part in the process of the deterioration of T2DM and the occurrence of vascular disease.