粒细胞-巨噬细胞集落刺激因子在早期判断糖尿病大血管病变的临床意义

Granulocyte-Macrophage Colony Stimulating Factor in Macroangiopathy of Non-Insulin-Dependent Diabetes Mellitus

采用放射免疫法测定了２１例健康人（Ａ组），６０例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者（Ｂ组），１９例无糖尿病的冠心病患者（Ｃ组）的血浆粒细胞－巨噬细胞集落刺激因子（ＧＭ－ＣＳＦ）。Ｂ组中按是否合并冠心病再分为三组：糖尿病不合并冠心病（１６例，Ｂ１组）；糖尿病合并可疑冠心病（１８例，Ｂ２组）；糖尿病合并冠心（２６例，Ｂ３组）。Ｃ组又分成两组：冠心病组（１１组，Ｃ１组）和可疑冠心病（８例，Ｃ２组）组。结果显示：Ｂ组ＧＭ－ＣＳＦ较Ａ组明显升高，差异有显著性（Ｐ＜０．０１）；糖尿病组中，Ｂ３组较Ｂ２组和Ｂ１组明显升高，三组比较差异有显著性（Ｐ＜０．０１、Ｐ＜０．０５）；Ｃ组中，Ｃ１组与Ｃ２组差异无显著性，但较Ａ组明显升高（Ｐ＜０．０５）。提示血浆ＧＭ－ＣＳＦ的改变与血管病变成正相关，尤其是糖尿病时更明显；ＧＭ－ＣＳＦ的测定将可能成为预测糖尿病大血管病变存在的一项指标。

The levels of granulocyte-macrophage colony stimulating factor(GM-CSF) were determined by radioimmunoassay in 21 cases of healthy people(Group A),60 cases of non-insulin-dependent diabetes mellitus(NIDDM,Group B) and 19 cases of coronary atherosclerotic heart disease(CHD,Group C).Group B can be divided into three groups according to whether these is CHD or not.Group B 1 has no CHD.Group B 2 is suspicious of CHD.Group B 3 has CHD.Group C can be divided into two groups.That is one group with CHD and another group suspicious of CHD.The results showed that the levels of GM-CSF in Group B were higher than that in the healthy people.In Group B,Group B 3 was higher than Group B 2 and Group B 1 (P<0.05,P<0.01).In Group C,Group C 1 was higher than Group A(P<0.05).These suggest that the levels of plasma GM-CSF are correlative with macroangiopathy,which is specially shown in Group B.Thus,the levels of plasma GM-CSF may be used to identify not only the macroangiopathy,but also critical state,and to pretell the macroangiopathy in Group B.