DR与多种细胞因子及红细胞变形能力相关性的临床研究  

Role of transfigurable ability of red blood cells and changes of serum levels of cytokines in type 2 diabetes mellitus with retinopathy

作　　者：耿芹[1] 任建民[2] 韩华[1] 李莉[1] 唐宽晓[2] 侯新国[2] 张秀英[1] 洪云[1] 

机构地区：[1]淄博市中心医院内科,山东淄博255036 [2]山东大学齐鲁医院内分泌科,山东济南250012

出　　处：《山东大学学报（医学版）》2005年第9期823-826,共4页Journal of Shandong University:Health Sciences

摘　　要：目的:观察2型糖尿病(T2DM)患者红细胞变形能力及细胞因子中肿瘤坏死因子-α(TNF-α)、血管细胞粘附分子(sVCAM-1)、内皮细胞生长因子(VEGF)在T2DM视网膜病变(DR)患者中的变化,探讨它在DR发病中的作用及临床意义。方法:选取85例T2DM患者和30例健康查体者,采用RIA法测定血清TNF-α浓度、采用ELISA法测定血清sVCAM-1、血浆VEGF水平,同时测定血液流变学指标,并分析各变量之间的相关性。结果:①T2DM各组血清TNF-α水平显著高于正常对照组(P均<0.01),且与餐后2h血糖(P2hBG)、糖化血红蛋白(HbA1c)、sVCAM-1呈正相关;②T2DM组红细胞变形能力明显低于正常对照组(P均<0.01),各组间亦有显著差异;③T2DM各组血清sVCAM-1水平显著高于正常对照组(P均<0.01),增殖型视网膜病变(PDR)组水平最高,与非增殖型视网膜病变(NPDR)组未见差异,但NPDR组高于非糖尿病视网膜病变(NDR)组(P<0.05);④PDR组血清VEGF水平显著高于正常对照组(P<0.05),NDR及NPDR组与正常对照组无统计学差异(P>0.05)。结论:T2DM血清TNF-α、sVCAM-1及红细胞变形能力的测定可作为早期预测DR和病情分析的指标;而VEGF可能主要在PDR期发挥促进新生血管形成的作用,对早期检测DR意义不大。Objective： To investigate the relationships between red blood cell transfigurable ability and serum levels of cytokines with type 2 diabetes with retinopathy. Methods： RBC transfigurable ability was measured by hepann anhagglutinin with automatism blood of flow propertics,and the serum levels of TNF-α were measured by radio-immunologic analyses （RIA）, sVCAM-1 level and VEGF level were measured by enzyme-link immunosobent assay（ELISA）in 85 cases of type 2 diabetes with or without retinopathy and 30 cases of normal controls. Results： （1）The levels of TNF-α in type 2 diabetes groups were significantly higher than those in control group（P〈0.01,respectively）.The level of TNF-α was significantly correlated with P2hBG, HbAlc and sVCAM-1 （r=0.585,P〈0.01 ;r=0.451 ,P〈0.05 ;r=0.401 ,P〈0.05）; （2） the transfigurable ability of RBC in type 2 diabetes groups were significantly lower than those in control group（P〈0.01,respectively）; （3） the levels of sVCAM-1 in type 2 diabetes groups were significantly higher than those in control group （P〈 0.01, respectively）; （4）the level of VEGF in proliferative diabetic retinopathy （PDR） group was significantly higher than that in control group（P〈0.05）.Conclusion：TNF-α,sVCAM-1 and transfigurable ability of RBC are significantly contributed to the diabetic retinopathy diseases. And TNF-α,sVCAM-1 and transfigurable ability of RBC are good indexes for early diagnosing and monitoring diabetic retinopathy, but the VEGF is not.

关 键 词：糖尿病 非胰岛素依赖型 糖尿病视网膜病变 红细胞变形能力 肿瘤坏死因子 血管细胞粘附分子-1 血管内皮生长因子 

分 类 号：R587.1[医药卫生—内分泌]