糖尿病痛性神经病变患者血清TNF-α、IL-6、MIF水平及足背动脉血管内皮依赖性舒张功能的研究  

Research on Serum TNF-α, IL-6, MIF Levels and the Endothelium Dilation of Dorsal Pedal Artery in Patients with Painful Diabetic Neuropathy

作　　者：柳岚[1] 闫晓洁[1] 叶艺艺[1] 蒋凤秀[1] 庄雄杰[1] 陆泽元[1] 

机构地区：[1]广东医学院附属深圳市福田人民医院内分泌科,广东深圳518033

出　　处：《热带医学杂志》2012年第11期1331-1334,共4页Journal of Tropical Medicine

基　　金：深圳市科技计划(医疗卫生类)立项项目(201003227)

摘　　要：目的研究糖尿病痛性神经病变(PDN)患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及巨噬细胞移动抑制因子(MIF)水平及足背动脉血管内皮依赖性舒张功能状况,并探讨其与疼痛的关系。方法 PDN患者26例入组,另选年龄、性别及病程上匹配的2型糖尿病伴神经病变的28例为DN组,2型糖尿病不伴神经病变30例为DM组,正常对照组28人。所有入组患者和健康对照者均检测空腹血糖(FPG)、餐后血糖(PPG)、空腹胰岛素(Fins)、糖化血红蛋白(HbA1C),测定血清TNF-α、IL-6及MIF水平,并用高分辨率超声检测足背动脉内径(D),评价血管内皮依赖性(EDD)及非内皮依赖性舒张功能(EID)。结果 PDN、DN及DM组血清TNF-α、IL-6、MIF水平均高于NC组,PDN及DN组血清TNF-α和MIF高于DM组,PDN组血清TNF-α和MIF高于DN组,差异有统计学意义。PDN、DN及DM组与NC组比较EDD差异有统计学意义,而EID的差异无统计学意义。Pearson相关分析显示,患者EDD与PPG、BMI、TNF-α、MIF、HOMA-IRI和HbA1C呈负相关。结论 PDN患者存在下肢血管内皮依赖性舒张功能受损;EDD、TNF-α、PPG和MIF为糖尿病患者发生PDN的独立危险因素。Objective To study the correlation of the serum levels of tumor necrosis factor-or （TNF-α）, interleukin-6 （IL-6）, and macrophage migration inhibitory factor （MIF）, and endothelium vasodilation of dorsal pedal artery with the painfulness in patients with painful diabetic neuropathy （PDN）. Methods 26 patients with painful diabetic ueuropathy were recruited as PDN group, another 28 patients with diabetic neuropathy as DN group, 30 patients with diabetes mellitus as DM group and 28 normal subjects were recruited as the control group （NC）. The fasting plasma glucose （ FPG ）, 2-hour postprandial glucose （PPG）, fasting serum insulin （Fins）, hemoglobinA 1C （HbA 1C ）, TNF-ot, IL-6, and MIF levels were measured. The body mass index（BMI）, and homeostasis model assessment-insulin resistant index（HOMA- IRI） were calculated. The endotbelium-dependent dilatation （EDD） and endothelium-independent dilatation （EID） Were measured by high-resolution ultrasound examining on dorsal pedal artery. Results The TNF-α, IL-6 and MIF levels were significant higher in PDN, DN and DM groups than those in NC group. The TNF-α and MIF levels were significant higher in PDN group than those in DN and DM groups. The TNF-α and MIF levels were significant higher in PDN group than those in DN group. The EDD were significant lower in PDN, DN and DM groups than those in NC group. Setting EDD as dependent variable for multiple linear stepwise regression, PPG, BMI, TNF-α, MIF, HOMA-IRI and HbA 1 C showed negative correlation. Conclusions The results suggested that endothelium-dependent dilatation function is impaired in patients with PDN. EDD, TNF-α, PPG and MIF are independent risk factors for PDN in diabetes patients.

关 键 词：糖尿病痛性神经病变 血清肿瘤坏死因子-Α 白细胞介素-6 巨噬细胞移动抑制因子 内皮舒张功能 

分 类 号：R587.1[医药卫生—内分泌]