糖尿病患者血清炎性因子与颈动脉粥样硬化关系的研究

目的研究糖尿病患者血清可溶性细胞间黏附分子-1（sICAM—1）、可溶性血管细胞黏附分子-1（SVCAM-1）、单核细胞趋化蛋白-I（MCP—1）和肿瘤坏死因子-α（TNF-α）水平与颈动脉粥样硬化程度的关系。方法2型糖尿病患者108例根据颈动脉彩色多普勒超声检查结果分为颈动脉正常组（19例）、颈动脉内膜增厚组（38例）、稳定斑块组（34例）、颈动脉狭窄组（17例）。采用酶联免疫吸附法测定各组血清sICAM-1、sVCAM-1、MCP-1和TNF—α水平，分析颈动脉硬化程度与血清炎性因子水平的关系。结果血清sICAM-1、sVCAM—1、MCP-1和TNF-α水平随着颈动脉硬化程度的增加而升高，各组指标比较均有统计学差异（P〈0．05）。颈动脉粥样硬化程度与皿清sICAM-1、sVCAM-1、MCP-1和TNF—α水平均呈显著正相关（t=0．675，P〈0．01；r=0．693，P〈0．01；r=0．723，P〈0．01；r=0．851，P〈0．01）。另外，各炎性因子之间呈正相关。结论2型糖尿病患者外周血中炎性因子水平可以在一程度上反映患者的颈动脉粥样硬化程度。

Relationhip between Serum Inflammatory Factors and Degree of Carotid Atherosclerosis in Patients with Type 2Diabetes Mellitus

Objective To study the relationship between the level of inflammatory factors such as soluble intercellular adhesion molecule-1 （sICAM-1）, soluble vascular cell adhesion molecular-1 （sVCAM-1）, monocyte chemoattractant protein-1 （MCP-1） and tumor necrosis factor-α （TNF-α） and the degree of carotid atheroselerosis in patients with type 2 diabetes mellitus. Methods 108 patients with type 2 diabetes mellitus were divided into four groups： normal carotid intima group （n=19）, carotid intima thicken group （n=38）, carotid plaque group （n=34） and carotid stenosis group （n=17） according to the results of color Doppler ultrasound examination of carotid artery. The levels of serum sICAM-1, sVCAM-1, MCP-1 and TNF-α in all groups were measured by enzyme-linked immunosorbent assay （ELISA）, and the relationship between the seriousness of the carotid atheroselerosis and the level of serum inflammatory factors were analyzed. Results The level of serum sICAM-I, sVCAM-1, MCP-1 and TNF-α continually was increased with the seriousness of carotid atherosclerosis. There were statistical significant differences between four groups （P〈0.05）. The seriousness of carotid atherosclerosis was significantly positively correlated with the levels of serum sVCAM-1, sICAM-1, MCP-1 and TNF-α （r=0.675, P〈0.01; r=-0.693, P〈0.01; r=0.723, P〈0.01; r=-0.851, P〈0.01, respectively）. In addition, there was significant positive correlation between the different levels of inflammatory factors. Conclusion The levels of inflammatory factors in the peripheral blood in patients with type 2 diabetes mellitus may reflect the seriousness of carotid atherosclerosis.