sCD40L、sICAM-1及炎症因子与T2DM患者血管病变相关性分析  

Correlation analysis between sCD40L, sicam-1 and inflammatory factors and vascular lesions in T2DM patients

作　　者：马建华 张乐 马建娥 李娜[2] MA Jian-hua;ZHANG Le;MA Jian-e(Department of Laboratory,Liaoning Health Industry Group Iron Coal General Hospital,Tieling Liaoning 112700,China)

机构地区：[1]辽宁省健康产业集团铁煤总医院检验科,辽宁铁岭112700 [2]西安交通大学第一附属医院检验科,陕西西安710061

出　　处：《临床和实验医学杂志》2020年第11期1191-1195,共5页Journal of Clinical and Experimental Medicine

基　　金：辽宁省重点研发指导计划项目(编号:2019JH8/10300066)。

摘　　要：目的探讨可溶性CD40配体(sCD40L)、可溶性细胞间粘附分子(sICAM-1)及炎症因子与2型糖尿病(T2DM)患者血管病变相关性。方法回顾性选择辽宁省健康产业集团铁煤总医院2017年1月至2019年9月收治的80例T2DM患者,根据是否存在心血管疾病将患者分为A组(T2DM+血管病变者,40例)及B组为T2DM组(40例),同时选择体检的40例健康人群作为C组(健康对照组)。比较三组受试者的血清胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、餐后2 h血糖(2 hPPG)、空腹血糖(FPG)、糖化血红蛋白(HbAlc)及胰岛素抵抗指数(HOMA-IR)水平;比较三组受试者的sCD40L、sICAM-1、白细胞介素6(IL-6)、肿瘤坏死因子α(TFN-α)、C反应蛋白(CRP)、内膜中层厚度(IMT)、左心室内径(LVD)、左心室后壁厚度(LVPWT)及室间隔厚度(IVST)值;分析血清sCD40L及sICAM-1与IL-6、CRP、TNF-α、TG、TC、HLD-C、LDL-C、HbAlc、HOMA-IR的相关性。结果A组患者的TG、TC、LDL-C水平明显高于B组及C组,A组的HDL水平明显低于C组,B组的TG、TC、LDL-C水平明显高于C组,HDL-C水平明显低于C组(P<0.05)。A组的2 h PPG、FBG、HbAlc、HOMA-IR、sCD40L、sICAM-1、IL-6、TFN-α、CRP水平、IMT、LVD、LVPWT、IVST值明显高于B组及C组(P<0.05),B组的以上指标水平明显高于C组(P<0.05)。血清sCD40L及sICAM-1与IL-6、CRP、TNF-α、HbAlc呈正相关(P<0.05),与TG、TC、HLD-C、LDL-C、HOMA-IR无相关性(P>0.05)。结论高水平sCD40L及sICAM-1与IL-6、CRP、TNF-α参与T2DM血管病变过程,对以上指标进行严格控制,有利于预防糖尿病血管并发症。Objective To investigate the correlation analysis between sCD40L,SICAM-1 and inflammatory factors and vascular lesions in T2DM patients.Methods 80 patients with T2DM admitted to our hospital from January 2017 to September 2019 were selected,and divided into group A(T2DM+vascular lesions,40 cases)and group B(T2DM group,40 cases)according to the presence or absence of cardiovascular diseases.Meanwhile,40 healthy patients in our hospital for physical examination were selected as group C(healthy control group).The serum TG、TC、HDL-C,LDL-C、PPG、FBG、HbAlc and HOMA-IR levels in three groups were compared.The sCD40L,sICAM-1,IL-6,TFN-α,CRP,IMT,LVD,LVPWT and IVST values in three groups were compared.The correlation of serum sCD40L and sICAM-1 with IL-6,CRP,TNF-α,TG,TC,HLD-C、LDL-C、HbAlc、HOMA-IR was analyzed.Results The TG and TC levels in group A were significantly higher than those in group B and C,and the HDL levels in group A was significantly lower than those in group C,the HDL-C levels was significantly higher than those in group C,the TG,TC and LDL-C levels in group B were significantly higher than those in group C,and HDL-C levels were significantly lower than those in group C,P<0.05.There was no significant difference in the other groups(P>0.05).The PPG,FBG,HbAlc,HOMA-IR,sCD40L,sICAM-1,IL-6,TFN-α,CRP level,IMT,LVD,LVPWT,IVST of group A were significantly higher than those of group B and group C,the above indicators in group B were significantly higher than those in group C(P<0.05).The serum sCD40L and SICAM-1 were positively correlated with IL-6,CRP,TNF-αand HbAlc(P<0.05),no correlation with TG,TC,HLD-C,LDL-C,HOMA-IR(P>0.05).Conclusion The high levels of sCD40L,SICAM-1,IL-6,CRP and TNF-αare involved in the vascular lesion process of T2DM,and strict control of the above indicators is conducive to the prevention of diabetic vascular complications.

关 键 词：T2DM血管病变 SCD40L SICAM-1 CRP TNF-α 相关性 

分 类 号：R587.2[医药卫生—内分泌] R543[医药卫生—内科学]