2型糖尿病合并脑梗死患者炎性因子水平、调控因子活性和血液流变学的变化  

The changes of inflammatory cytokines,regulatory factor activity and hemorheology in patients with type 2 diabetes mellitus complicated by cerebral infarction

作　　者：黄敏[1] 张红梅[1] 段微[1] 尹虹祥[2] 许康[2] 

机构地区：[1]湖北省新华医院内分泌科,武汉市430015 [2]湖北省新华医院神经内科,武汉市430015

出　　处：《河北医药》2014年第21期3220-3222,共3页Hebei Medical Journal

基　　金：湖北省卫生厅科研基金项目(编号:JX6B88)

摘　　要：目的探讨2型糖尿病合并脑梗死患者的炎症因子,包括超敏C-反应蛋白(hs-CRP)、白介素6(IL-6)、IL-8、肿瘤坏死因子-α(TNF-α)水平,和调控因子内源性核因子κB(NF-κB)活性及血液流变学指标的变化。方法对照组、单纯脑梗死组、单纯2型糖尿病组、2型糖尿病合并脑梗死组,每组60例,共240例。血清hs-CRP采用免疫荧光分析法检测,血清IL-6、IL-8、TNF-α采用ELISA法检测。外周血NF-κB活性采用免疫组织化学法检测。全自动血液流变仪测定血液流变学指标。将2型糖尿病合并脑梗死组的外周血NF-κB活性与血液流变学指标进行相关性分析。结果 2型糖尿病合并脑梗死组血清hs-CRP、IL-6、IL-8、TNF-α水平分别为(14.33±5.65)mg/L,(25.45±6.98)ng/L,(103.35±21.58)ng/L,(35.69±6.72)ng/L,均显著高于其他3组(P<0.01)。2型糖尿病合并脑梗死组外周血NF-κB活性为(133.68±23.02)pg/ml,显著高于其他3组(P<0.01)。2型糖尿病合并脑梗死组全血低切黏度、全血高切黏度、血浆黏度、纤维蛋白原、红细胞聚集指数和血小板最大聚集率非别为(30.51±4.14)mPa·s,(6.99±1.05)mPa·s,(2.12±0.27)mPa·s,(6.75±0.84)g/L,(9.91±1.56)和(87.14±15.72)%,均显著高于其他3组(P<0.01)。2型糖尿病合并脑梗死患者中NF-κB活性与全血低切黏度、高切黏度、血浆黏度、纤维蛋白原、红细胞聚集指数以及血小板最大聚集率呈显著正相关(r=0.637、0.529、0.502、0.644、0.517、0.681,P均<0.01)。结论在长期高血糖作用下,炎性因子(hs-CRP、IL-6、IL-8和TNF-α)水平升高,炎性因子可以激活NF-κB,导致血液流变学异常,使血液处于高粘、高凝状态,血流缓慢,易于形成血栓,引起和加速2型糖尿病合并脑梗死的发生和发展;NF-κB可作为2型糖尿病合并脑梗死患者治疗中新型的药物靶点。Objective To investigate the changes of inflammatory cytokines including hs-CRP,IL-6,IL-8,TNF-α,the activity of regulatory factor-NF-κBand hemorheology in patients with type 2 diabetes mellitus complicated by cerebral infarction.Methods A parallel-controlled study was performed in the four groups including control group （ n =60）,simple cerebral infarction group （ n =60）,simple type 2 diabetes group（ n =60）,type 2 diabetes with cerebral infarction group （ n=60） .The serum levels of hs-CRP were detected by immunofluorescence assay ,the serum levels of IL6-,IL-8 and TNF-αwere measured by ELISA,and NF-κB activity was detected by immunohistochemistry .The hemorrheology parameters were detected by fully-automatic blood rheometer, and the correlation between NF-κB activity in peripheral blood of patients with type 2 diabetes mellitus complicated by cerebral infarction and hemorrheology parameters were analyzed.Results The serum levels of hs-CRP,IL-6,IL-8,TNF-αand activity of NF-κB in type 2 diabetes with cerebral infarction group were significantly higher than those in the other three groups （ P 〈0.01）.The hemorrheology parameters in type 2 diabetes with cerebral infarction group were significantly higher than those in the other three groups （ P 〈0.01） .Furthermore,the activity of NF-κB in type 2 diabetes with cerebral infarction group was positively correlated to hemorrheology parameters including whole blood low-shear viscosity,highs-hear viscosity,plasma viscosity,Fib,erythrocyte aggregation index and platelet maximum aggregation rate （ P 〈0.01）.Conclusion The levels of hs-CRP,IL-6,IL-8 and TNF-α are increased by the effect of long-term hyperglycemia, which can activate NF-κB to result in abnormal hemorheology status including high viscosity,hypercoagulability and blood flow slowing,which is easy to form thrombus and induce the pathogenesis and development of type 2 diabetes mellitus complicated by cerebral infarction.Therefore,NF-κB can be used as an new drug target in tr

关 键 词：糖尿病 脑梗死 炎性因子 调控因子 血液流变学 

分 类 号：R587.2[医药卫生—内分泌]