2型糖尿病合并急性脑梗死患者颈动脉粥样硬化及血清脂联素、可溶性细胞间黏附分子-1和可溶性血管细胞间黏附分子-1水平分析  

Analysis of carotid atherosclerosis and the levels of serum adiponectin,soluble intercellular adhesion molecule-1 and soluble vascular cell adhesionmolecula-1 in patients with type 2 diabetes mellitus complicated with acute cerebral infarction

作　　者：付彦[1] FU Yan(Department of Stroke,Beijing Geriatric Hospital,Beijing 100095,China)

机构地区：[1]北京老年医院卒中一科,北京100095

出　　处：《新乡医学院学报》2020年第7期674-677,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨2型糖尿病(T2DM)合并急性脑梗死(ACI)患者颈动脉粥样硬化程度及血清脂联素(APN)、可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞间黏附分子-1(sVCAM-1)水平变化。方法选择2017年12月至2019年1月北京老年医院收治的90例T2DM患者为研究对象,其中单纯T2DM患者28例作为对照组,T2DM合并ACI患者62例作为观察组。应用彩色多普勒超声诊断仪对2组患者颈总动脉、颈外动脉、颈内动脉颅外段、颈内外动脉分叉部进行扫描检查,测量血管内膜-中层厚度(IMT),记录粥样硬化斑块数目、性质及部位,并测量血管管径,计算颈动脉狭窄率(颈动脉狭窄≥50%)。采用免疫散射比浊法检测患者血清APN、C反应蛋白(CRP)水平,采用酶联免疫吸附试验检测血清sICAM-1、sVCAM-1水平,并分析T2DM合并ACI患者血清APN与sICAM-1、sVCAM-1的相关性。结果对照组和观察组患者颈动脉粥样硬化斑块发生率分别为71.43%(20/28)、91.94%(57/62),观察组患者颈动脉粥样硬化斑块发生率高于对照组(χ^2=6.563,P<0.05)。2组患者颈动脉粥样硬化斑块性质及分布部位比较差异无统计学意义(χ^2=3.236、4.178,P>0.05)。对照组和观察组患者颈动脉狭窄率分别为17.86%(5/28)、20.97%(13/62),2组患者颈动脉狭窄率比较差异无统计学意义(χ^2=0.116,P>0.05)。观察组和对照组患者颈动脉IMT分别为(1.36±0.17)、(1.08±0.05)mm,观察组患者颈动脉IMT大于对照组(t=8.526,P<0.05)。与对照组比较,观察组患者血清APN水平显著降低,血清CRP、sICAM-1和sVCAM-1水平显著升高(P<0.05)。直线相关分析显示,T2DM合并ACI患者血清APN与sICAM-1、sVCAM-1水平呈负相关(r=-0.294、-0.213,P<0.05)。结论T2DM合并ACI患者血清APN水平降低,sICAM-1、sVCAM-1水平升高;APN是T2DM患者动脉粥样硬化发生发展中的保护因素,sICAM-1、sVCAM-1可能参与了T2DM患者动脉粥样硬化过程。检测T2DM患者血清APN、sICAM-1、sVCAM-1水平有助于Objective To investigate the degree of carotid atherosclerosis and the changes of serum adiponectin(APN),soluble intercellular adhesion molecule-1(sICAM-1)and soluble vascular cell adhesionmolecula-1(sVCAM-1)levels in patients with type 2 diabetes mellitus(T2DM)complicated with acute cerebral infarction(ACI).Methods Ninety patients with T2DM admitted to Beijing Geriatric Hospital from December 2017 to January 2019 were selected as the research subjects,including 28 patients with simple T2DM(control group)and 62 patients with T2DM combined with ACI(observation group).The common carotid artery,the external carotid artery,the extracranial segment of the internal carotid artery and the bifurcations of the internal and external carotid arteries were scanned with the color Doppler ultrasound diagnostic instrument.The intima-media thickness(IMT)of the arteries was measured,and the number,character and location of the atherosclerotic plaques were recorded,and the carotid stenosis(carotid stenosis≥50%)rate was calculated.The levels of serum APN and C-reactive protein(CRP)were detected by immunoturbidimetry,the levels of serum sICAM-1 and sVCAM-1 were detected by enzyme linked immunosorbent assay,and the correlation between serum APN and sICAM-1 and sVCAM-1 in patients with T2DM complicated with ACI was analyzed.Results The incidence of carotid atherosclerotic plaques in the control group and the observation group was 71.43%(20/28)and 91.94%(57/62),respectively.The incidence of carotid atherosclerotic plaques in the observation group was higher than that in the control group(χ^2=6.563,P<0.05).There was no significant difference in the character and distribution of carotid atherosclerotic plaque between the two groups(χ^2=3.236,4.178;P>0.05).The carotid artery stenosis rate in the control group and the observation group was 17.86%(5/28)and 20.97%(13/62),respectively.There was no significant difference in the carotid artery stenosis rate between the two groups(χ^2=0.116,P>0.05).The IMT of carotid artery in the observati

关 键 词：2型糖尿病 急性脑梗死 动脉粥样硬化 脂联素 可溶性细胞间黏附分子-1 可溶性血管细胞间黏附分子-1 

分 类 号：R587.1[医药卫生—内分泌]