白细胞表面分化抗原40配体在糖尿病患者下肢血管内皮细胞及平滑肌细胞中的表达

The expression of CD40L in vascular endothelium and smooth muscle cells with diabetic vasculopathy

目的观察白细胞表面分化抗原40配体（CD40L）在糖尿病患者下肢血管内皮细胞及平滑肌细胞中的表达，探讨CD40L与糖尿病下肢血管病变发生发展的关系。方法选择2007年11月-2008年4月间因外伤或罹患糖尿病足、需要行截肢手术而在我院就诊的单纯糖尿病患者10例、糖尿病下肢血管病变者12例、非糖尿病单纯下肢血管病变者10例以及对照组8例。测定其血糖、血脂、糖化血红蛋白等，用免疫组织化学方法检测下肢动脉血管内皮细胞及平滑肌细胞中CD40L的表达，用计算机图像分析技术半定量检测CD40L的表达。结果糖尿病下肢血管病变组、单纯糖尿病组、单纯下肢血管病变组的CD40L表达均较对照组增强（P〈0．05）；糖尿病下肢血管病变组的CD40L表达较单纯糖尿病组和单纯下肢血管病变组增强（P〈0．05）；CD40L的表达与空腹血糖值呈正相关（r=0．542，P〈0．001）。结论CD40L是参与糖尿病血管病变的重要炎症因子，高血糖可促发CD40L过度表达。

Objective To determine the expression of CD4oL in vascular endothelium and smooth muscle cell with diabetic vasculopathy. Methods Patients hospitalized in The First Affiliated Hospital of Medical school Shihezi University from November 2007 to April 2008 ,who were subjected to lower-extremity amputation were selected randomly consisting of diabetes without any complications （n = 10） , diabetes with lower extremity vasculopathy （ n = 12 ）, nondiabetic with vasculopathy （ n = 10 ）, and normal control （ n =8 ）. Blood glucose, blood fat, HbA1 c were test by biochemistry technique and the expression of CD40 L in vascular endothelium and smooth muscle cell in their lower extremity artery were determinded by immunohistochemical methods. Results The expression of CD40 L was more enhanced in diabetic patients with and without vasculopathy, and in nondiabetic patients with vasculopathy than that in normal persons （ P 〈 0.05 ）. CD40 L expressed higher in the diabetic with vasculopathy than either those diabetic without vaseulopathy or those nondiabetic with vasculopathy （P 〈 O. 05 ）. There is a positive relationship between CD40 L expression and Fasting blood glucose（ r = 0. 542 ,P 〈 0. 001 ）. Conclusion CD40L is an important inflammatory factor which participates the development of diabetic vasculopathy. Hyperglycemia can promote the excessive expression of CD40L.