组织蛋白酶S与糖尿病患者颈动脉内膜中膜厚度的关系

The Relationship Study Between Cathepsin S and Atherosclerosis in Diabetes

目的探讨组织蛋白酶S在糖尿病动脉粥样硬化发生发展过程中的作用。方法 83位糖尿病患者按颈动脉内膜中膜厚度（IMT）分为3组。糖尿病伴中度动脉粥样硬化组20例,IMT≥1.0 mm,或有一个以上动脉粥样硬化斑块;糖尿病伴轻度动脉粥样硬化组23例,IMT 0.8-0.99 mm,糖尿病不伴动脉粥样硬化组40例,IMT〈0.8 mm;正常对照组21例。所有对象均测定组织蛋白酶S、颈动脉内膜中膜厚度、糖化血红蛋白（HbA1 c）、血糖、血脂。结果糖尿病伴中度动脉粥样硬化组和糖尿病伴轻度动脉粥样硬化组组织蛋白酶S值与正常对照组比较显著升高（P〈0.001）,且组织蛋白酶S值随着颈动脉内膜中膜厚度的增加而升高,成正比关系;糖尿病不伴动脉粥样硬化组组织蛋白酶S值与正常对照组比较差异无显著性（P〉0.05）,与糖尿病伴中度动脉粥样硬化组和糖尿病伴轻度动脉粥样硬化组比较差异有显著性（P〈0.001）;糖尿病3组组间糖化血红蛋白、血糖、血脂差异均无显著性（P〉0.05）,与正常对照组比较差异有显著性（P〈0.01）。结论组织蛋白酶S在糖尿病动脉粥样硬化患者血清中显著升高,且随着颈动脉内膜中膜厚度值的增加值越高,血清组织蛋白酶S测定可以作为诊断糖尿病动脉粥样的监测指标。

Aim To explore the relationship between cathepsin S in the process occurrence and development of atherosclerosis in diabetes. Methods 83 diabetic patients detected by carotid artery intima-media thickness（IMT） were divided into three groups： 20 diabetic cases with moderate atherosclerosis group,IMT≥1.0 mm,or with more than one atherosclerotic plaque;23 diabetic cases with mild atherosclerosis group,IMT 0.8~0.99 mm;40 diabetic cases without atherosclerosis group,IMT 0.8 mm;21 cases of normal control group.The levels of HbA1c,CatS,blood glucose,blood lipids,IMT results were measured in all subjects. Results Compared with the control group CatS value was significantly higher in diabetic group with moderate atherosclerosis and mild atherosclerosis（P0.001）,and increased positively with IMT;CatS value had no significant change in diabetic group without atherosclerosis and the normal control group（P0.05）;compared with the first group and the second group CatS value was significantly different（P0.001）;in the diabetic group of glucose,blood lipids,HbA1c was not significantly different（P0.05）,and in normal control group was significantly different（P0.01）. Conclusion CatS level in diabetic patients was significantly increased,and related to IMT values.CatS determination of serum can be used as diagnostic indicators for monitoring diabetes,atherosclerosis.