炎症因子在2型糖尿病大血管病变患者中意义及其相关性  

The Significance of Inflammatory Cytokines in T2DM Patients with Macrovascular Disease and Its Correlation

作　　者：汪茂荣[1] 姚平[1] 

机构地区：[1]湖北民族学院附属民大医院内分泌科,湖北恩施445000

出　　处：《湖北民族学院学报（医学版）》2015年第2期15-18,共4页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的探讨炎症因子白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)及C-反应蛋白(CRP)与2型糖尿病(T2DM)大血管病变的关系。方法选取2012年6月至2014年6月本院收治的124例T2DM患者为研究对象,根据彩色多普勒超声诊断结果将患者分为T2DM无大血管病变组(G1组)68例及合并大血管病变组(G2组)56例。另选取同期行身体检查的60例正常体检者为对照组,应用放射免疫法测定三组CRP水平,应用酶联免疫法测定三组IL-8、TNF-α水平,分析CRP、IL-8、TNF-α与空腹胰岛素(FINS)、空腹血糖(FBG)、同型半胱氨酸(Hcy)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、同型半胱氨酸(Hcy)、体重指数(BMI)、腰臀比(WHR)的关系。结果 G2组血清CRP、IL-8、TNF-α水平、FINS、HOMA-IR、冠心病史、脑卒中史高于G1组(P<0.05),G1组与G2组血清CRP、IL-8、TNF-α、FINS、FBG、Hcy、TG、TC、LDL-C、WHR水平、高血压史、冠心病史、脑卒中史显著高于对照组(P<0.05)。经Pearson相关因素分析可知,CRP与IL-8、TNF-α、FINS、HOMA-IR呈正相关(P<0.05)。IL-8与TNF-α、FINS呈正相关(P<0.05)。TNF-α与FINS、HOMA-IR呈正相关(P<0.05)。经Logistic多因素回归分析可知,CRP、IL-8、TNF-α、FINS、HOMA-IR是导致T2DM大血管病变的独立危险因素。结论 CRP、IL-8、TNF-α可能是T2DM合并大血管病变的危险因子,三者可能通过胰岛素抵抗及相关作用参与T2DM大血管病变的发生及进展过程。Objective To investigate the macrovascular relationship of inflammatory cytokines interleukin-8（ IL-8）,tumor necrosis factor-a（ TNF-α） and C-reactive protein（ CRP） and type 2 diabetes（ T2DM）.Methods 124 cases T2 DM patients were divided into T2 DM no major vascular disease（ G1 group,n = 68） and merger macrovascular disease group（ G2 group,n = 56） from June 2012 to June 2014.60 normal volunteers were selected as control group.The levels of CRP of three groups were measured by enzyme-linked and the levels of IL-8,TNF-α were measured by immunosorbent assay. The relationship of CRP,IL-8,TNF-α and fasting insulin（ FINS）,fasting blood glucose（ FBG）,homocysteine（ Hcy）,triglycerides（ TG）,total cholesterol（ TC）,low-density lipoprotein（ LDL-C）,high density lipoprotein（ HDL-C）,homocysteine（ Hcy）,body mass index（ BMI）,waist-hip ratio（ WHR） were analized.Results The levels of CRP,IL-8,TNF-α,FINS,HOMA-IR,coronary heart disease,history of stroke of G2 groups were higher than the G1 group（ P〈0.05）.The levels of CRP,IL-8,TNF-α,FINS,FBG,Hcy,TG,TC,LDL-C,WHR and history of hypertension,coronary heart disease,history of stroke of G1 and G2groups（ P〈0.05）.The CRP were positively correlated with IL-8,TNF-α,FINS,HOMA-IR（ P〈0.05）.IL-8 were positively correlated with TNF-α,FINS（ P〈0. 05）. TNF-α were positively correlated with FINS,HOMA-IR（ P〈0.05）.After Logistic regression analysis shows,CRP,IL-8,TNF-α,FINS,HOMAIR was big lead T2 DM independent risk factor for vascular disease.Conclusion CRP,IL-8,TNF-α may be T2 DM combined macrovascular disease risk factors may be involved in the three and macrovascular disease progression T2 DM by insulin resistance and related effects.

关 键 词：白细胞介素-8 肿瘤坏死因子-Α C-反应蛋白 大血管病变 糖尿病 

分 类 号：R587.1[医药卫生—内分泌]