糖尿病微血管病变患者细胞黏附分子的表达与尿白蛋白相关性研究

Relationship between the Expression of Cell Adhesion Molecules in Type 2 Diabetes Patients with Microangiopathy and Urine Albuminuria

目的探讨2型糖尿病(T2DM)微血管病变患者细胞黏附分子(cell adhesion molecules,CAMs)的表达水平与尿白蛋白的相关性。方法采用酶联免疫法、流式细胞术和放射免疫法分别测定129例T2DM患者(其中95例合并微血管病变)和39例健康对照者外周血中的SICAM-1水平及CD11b、CD62P、CD63的表达和尿微量白蛋白排泄率(urinary albumin excretion,UAER)。结果糖尿病各组SICAM-1水平和CD11b、CD62P、CD63的表达均明显高于对照组(P<0.05及0.01);有微血管病变正常蛋白尿组CD63的表达与无微血管病变组比较,差异无显著性(P>0.05),而SICAM-1水平和CD11b、CD62P的表达则均明显高于无微血管病变者(P<0.05及0.01);微量蛋白尿组和临床蛋白尿组的SICAM-1水平和CD11b、CD62P、CD63的表达与无微血管病变者比较,均随着病情的加重而增加,差异均有统计学意义(P<0.05及0.01);相关分析SICAM-1水平和CD11b、CD62P、CD63的表达均与UAER呈正相关(P<0.05)。结论2型糖尿病患者CAMs的高表达与微血管病变密切相关,联合UAER检测对诊断、观察病情及防止患者微血管病变和血栓的发生发展均有意义。

Objective To explore relationship between the expression of cell adhesion molecules （CAMs） in type 2 diabetes patients with microangiopathy and urine albuminuria. Method The expression of CAMs （CDI lb, CD62P and CD63） were determined by flow cytometry （FCW）; SICAM-1 was determined by ELISA; Urine Albuminuria was determined by RIA. 129 cases of patients （including 95 cases of patients with mieroangiopathy）, and 39 cases of healthy people were examined. Result The expression levels of CAMs in all type 2 diabetes patients were significantly higher than those in healthy people （P〈0.05-0.01）. There was no difference in the expression of CD63 between albuminuria patients with mieroangiopathy and the patients without microangiopathy （P〉0.05）. But the expression levels of SICAM-1 ,CDllb and CD62P in albuminuria patients with microangiopathy were higher than those in patients without microangiopathy （P〈0.05-0.01）. The expression of CAMs in microalbuminuria and clinical albuminuria patients were significantly higher than those in patients without microangiopathy （P〈0.05-0.01）. With the patient＇s condition becoming more serious, the expression levels of the four molecular markers were getting higher and higher in these patients. The expression levels of SICAM-1, CDllb, CD62P and CD63 were all correlated with urine albumin excretion （UAER,P〈0.05）. Conclusion The enhanced expression of CAMs in type 2 diabetes patients were closely associated with microangiopathy. Expression levels of CAMs combined with UAER are useful markers for diagnosis and monitoring the clinical course to type 2 diabetes patients with microangiopathy, avoiding diabetic angiopathies and thrombus.