2型糖尿病患者血清生长因子β1浓度异常与术中不良心血管事件的关系  

Relationship between abnormal serum transforming growth factor β1 concentration and intraoperative adverse cardiovascu⁃lar events in patients with type 2 diabetes

作　　者：邓文涛 赵向凤 储小飞 郭政[1,2] Deng Wentao;Zhao Xiangfeng;Chu Xiaofei;Guo Zheng(Department of Anesthesiology,Shanxi Medical University,Taiyuan 030000,China;Department of Anesthesiology,Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学麻醉学系,太原030000 [2]山西医科大学第二医院麻醉科,太原030001

出　　处：《国际麻醉学与复苏杂志》2020年第9期866-871,共6页International Journal of Anesthesiology and Resuscitation

摘　　要：目的研究2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清转化生长因子β1(transforming growth factor β1,TGF‐β1)浓度异常与术中不良心血管事件(adverse cardiovascular event,ACVE)的关系。方法椎管内麻醉下行择期膝关节置换术患者94例,年龄50~79岁,性别不限,ASA分级Ⅱ、Ⅲ级。其中:非糖尿病(无周围神经病变)患者31例(NDM组),单纯糖尿病(无周围神经病变)患者29例(DM组),糖尿病合并周围神经病变患者34例(DPN组)。采用ELISA法测定术前血清TGF‐β1浓度,观察记录3组患者术中ACVE发生率。分析糖尿病患者血清TGF‐β1浓度与术中ACVE的关系。结果糖尿病患者血清TGF‐β1明显高于非糖尿病患者(P<0.05),并发周围神经病变的糖尿病患者血清TGF‐β1水平明显高于未并发神经病变糖尿病患者(P<0.05)。NDM组、DM组、DPN组术中ACVE发生率、血清TGF‐β1浓度均呈现NDM组<DM组<DPN组,各组间差异有统计学意义(P<0.05)。纳入病例总体比较时,发生ACVE患者TGF‐β1浓度[(1359±424)ng/L]明显高于未发生ACVE患者[(1162±401)ng/L](P<0.05)。进一步行组内比较,DPN组内发生ACVE患者TGF‐β1浓度[(1578±230 ng/L)]高于未发生ACVE患者[(1273±135)ng/L](P<0.05),但DM组、NDM组组内比较差异未显示统计学意义(P>0.05)。结论糖尿病、糖尿病周围神经病变与血清TGF‐β1显著升高有关,TGF‐β1异常升高与糖尿病合并周围神经病变患者术中ACVE的发生有关。其相关作用机制有待进一步研究。Objective The study aims to investigate the relationship between abnormal concentration of serum transforminggrowth factor β1 (TGF-β1) and intraoperative adverse cardiovascular event (ACVE) in patients with type 2 diabetes mellitus (T2DM).Methods Ninety-four patients undergoing elective knee arthroplasty under spinal anesthesia were assigned to diabetes group (non-peripheralneuropathy) (DM group, n=29), diabetic peripheral neuropathy group (DPN group, n=34) and non-diabetes group (non-peripheralneuropathy) (NDM group, n=31). The patients ranged in age from 50 to 79 years, and were not limited to men and women, AmericanSociety of Anesthesiologists (ASA) Ⅱ or Ⅲ. Preoperative serum TGF-β1 concentrations were measured using enzyme-linked immunosorbentmethod. The incidence of ACVE in three groups was observed and recorded. To analyze the relationship between serum TGF-β1concentration and intraoperative ACVE in diabetic patients. Results The level of serum TGF-β1 in diabetic patients was significantlyhigher than that in non-diabetic patients (P<0.05), and the level of serum TGF-β1 in diabetic patients with peripheral neuropathy wassignificantly higher than that in diabetic patients without neuropathy (P<0.05). The incidence of intraoperative ACVE and theserum TGF-β 1 concentrations in the NDM group, DM group and DPN group presented a consistent order as NDM group<DMgroup<DPN group, with the differences showing statistical significance (P<0.05). When included in the overall comparison ofcases, the concentration of TGF-β1 in patients with ACVE was significantly higher than that in patients without ACVE [(1 359±424) ng/Lvs (1 162±401) ng/L, P<0.05]. Further intra-group comparison showed that the concentration of TGF-β1 in patients with ACVE in DPN group was significantly higher than that in patients without ACVE [(1 578±230) ng/L vs (1 273±135) ng/L, P<0.05]. However, there wasno statistical difference both DM group and NDM group (P>0.05), when making intra-group comparisons. Conclusions Diabetesmellitus

关 键 词：2型糖尿病 不良心血管事件 转化生长因子Β1 

分 类 号：R587.2[医药卫生—内分泌] R747.9[医药卫生—内科学]