检索历史 清除

目的 探讨2型糖尿病患者血清可溶性细胞间黏附分子1(sICAM-1)、血管细胞黏附分子1(sVCAM-1)及高敏CRP(hsCRP)水平与下肢大血管病变程度的关系.方法 对130例2型糖尿病患者(糖尿病组)与30例年龄匹配的体检健康者(对照组)血清sICAM-1、sVCAM-1、hsCRP及生化指标水平进行测定,同时行下肢动脉彩色多普勒超声检查.糖尿病组根据病变性质及严重程度评分分为血管无病变组(26例)、血管轻度病变组(45例)和血管中重度病变组(59例).比较各组间指标水平,对sICAM-1、sVCAM-1分别进行单因素相关分析,下肢血管病变与各项危险因素的Person相关性分析,以下肢血管评分作为应变量行多元逐步回归分析.结果 糖尿病血管中重度病变组的sICAM-1[(385±88) μg/L]、sVCAM-1 [(811±293) μg/L]水平,高于血管轻度病变组[(292±84) μg/L与(572±189) μg/L]、血管无病变组[(282±56) μg/L与(450±176) μg/L]和对照组[(239 ±60)μg/L与(358±177)μg/L](t值为4.15 ～8.93,均P＜0.05)；hsCRP水平为(1.61±1.01)mg/L,高于血管轻度病变组(1.04 ±0.79) mg/L、血管无病变组(0.59 ±0.34) mg/L和对照组(0.92±0.56) mg/L(t值为2.18 ～4.27,均P＜0.05).sICAM-1水平与TC、LDL-C、sVCAM-1水平呈正相关r值分别为0.23、0.20和0.49,均P＜0.05,sVCAM-1水平与病程、收缩压、hsCRP呈正相关(r值分别为0.24、0.18和0.21,均P＜0.05).结论 T2DM患者sICAM-1、sVCAM-1及hsCRP水平与下肢大血管病变程度有关,其升高与高血压、脂代谢紊乱及炎症反应相关.

Objective To investigate the association of serum levels of soluble intercellular cell adhesion molecule-1 (sICAM-1),soluble vascular cell adhesion molecule-1 (sVCAM-1) and high sensitivity C-reactive protein (hs-CRP) with peripheral vascular disease of lower limbs in patients with type 2 diabetes mellitus (T2DM).Methods One hundred and thirty T2DM patients admitted from October 2011 to October 2012,and 30 age/sex-matched healthy subjects were enrolled in the study.The serum levels of sICAM-1,sVCAM-1,hs-CRP and other clinical parameters were measured; the peripheral blood vessels of lower limbs were examined with color Doppler ultrasonography.Based on the extent of angiopathy of lower limbs T2DM patients were classified as normal vascular group (n =26),mild angiopathy group (n =45),moderate/severe angiopathy group (n =59).Results The serum levels of sICAM-1 and sVCAM-1 in moderate/ severe angiopathy group of T2DM patients were higher than those in mild angiopathy group,normal vascular group and healthy controls (t:4.15-8.93,all P ＜0.05) ; the serum levels of hs-CRP in moderate/severe angiopathy group were higher than those in mild angiopathy group,normal vascular group and healthy controls (t:2.18-4.27,all P ＜ 0.05).The serum sICAM-1 level was positively correlated with total cholesterol (TC),low density lipoprotein cholesterol (LDL-C) and sVCAM-1.The serum sVCAM-1 level was positively correlated with course of disease,systolic blood pressure and CRP.Conclusions Serum levels of sICAM-1,sVCAM-1 and hs-CRP are correlated with the extent of angiopathy of lower limbs in T2DM patients,and the elevated sICAM-1 ; sVCAM-1 and hs-CRP levels are also associated with hyper blood pressure,dislipidemia and chronic inflammation.