2型糖尿病患者血清可溶性血管细胞粘附分子-1和选择素-E检测的临床意义

Clinical significance of detecting the levels of serum soluble vascular cell adhesion molecule-1 and soluble E-selectin in type 2 diabetes mellitus patients

目的研究可溶性血管细胞粘附分子-1(sVCAM-1)和可溶性E-选择素(sE-selectin)在2型糖尿病患者血管病变中的变化及其临床意义。方法应用酶联免疫吸附法检测78例2型糖尿病患者(其中并发大血管病变21例,并发微血管病变34例,无微血管病变23例)、28例葡萄糖耐量减退(IGT)组、21例空腹血糖受损(IFG)组和33名健康对照者的血清sVCAM-1和sE-selectin水平。结果2型糖尿病组和IGT组血清中sV- CAM-1和sE-selectim水平显著高于健康对照组(P＜0．01)；糖尿病伴大血管病变组血清sVCAM-1、sE-selectin显著高于微血管病变组,伴微血管病变高于无微血管病变患者(P＜0．01)；IFG组检测结果与正常对照差异无统计学意义在不同数量的微血管病变组间,血清svcAM-1和sE-selectin存在显著性差异(P＜0．05)；sV- CAM-1和sE-selectin存在相关性(γ=0．42,P＜0．05)；sE-selectin与GHb存在相关性(γ=0．59,P＜0．01)。结论VCAM-1和sE-selectin可能参与了2型糖尿病血管病变的发生和发展,检测血清sVCAM-1和sE-selectin水平在一定程度上可反映2型糖尿病血管病变的情况。

Objective To investigate the changes of serum levels of soluble vascular cell adhesion molecule-1 （sVCAM-1） and soluble E-Selectin （sE-selectin） in type 2 diabetes mellitus with angiopathy. Methods Serum levels of sVCAM-1 and sE-selectin were measured with ELISA in 78 cases of type 2 diabetic mellitus （including 21 patients with macroangiopathy , 34 patients with microangiopathy and 23 without microangiopathy ） , 28 cases of impaired glucose tolerance（1GT）, 21 cases of impaired fasting blood glucose（1FG） and 33 cases of healthy subjects, Results The serum levels of sVCAM-1 and sE..selectin in type 2 diabetes mellitus and IGT were significantly higher than those in healthy subjects （ P 〈 0,01） ; The levels of these markers in type 2 diabetes mellitus patients with macroanglopathy increased significantly in comparison with those with microangpathy. The concentrations of sVCAM-1 and sE-selectin in type 2 di abetes mellitus with microanglopathy was much higher than those without microanglopathy （ P 〈 0,01）, and there were significant difference between single and multiple mlcroanglopathy , but there were no significant difference between patients with IFG and controls, The serum levels of sVCAM -1 in diabetes mellitus had correlation with serum levels of sE -selectin （γ= 0.42, P 〈 0,05）, The serum levels of sE-selectin had correlation with serum levels of GHb （γ= 0.59, P 〈 0,01） . Conclusion The E-selectin and VCAM-1 may play a certain role in type 2 diabetes mellitus with vascular complications , The serum levels of sVCAM-1 and sE-selectin may reflect vascular pathological changes in type 2 diabetes patients to a certain extent,