钙拮抗剂对2型糖尿病大血管病变患者外周血白细胞CD55、CD59表达的影响

Effects of calcium antagonist on complement regulatory proteins CD55 and CD59 expression in peripheral blood leucocytes of patients with type 2 diabetes and macrovascular diseases

目的观察钙拮抗剂对糖尿病大血管病变患者外周血白细胞CD55、CD59表达的影响。方法56例2型糖尿病合并大血管病变患者，根据是否应用钙拮抗剂药物分为钙拮抗剂组22例和对照组34例。获取血标本检测血糖、血脂；用流式细胞术测定外周血白细胞（淋巴细胞、单核细胞和中性粒细胞）上CD55和CD59的表达；用超声波测定颈动脉内中膜厚度。结果两组间在性别、年龄、病程、体重指数、腰臀比、空腹血糖、糖化血红蛋白、空腹c肽、血脂、血压、超敏c-反应蛋白及颈动脉内中膜厚度差异无统计学意义。与对照组相比，钙拮抗剂组外周血白细胞总数、中性粒细胞数及单核细胞数无变化；淋巴细胞数明显下降[（2．05±0．66）×109／LVS（1．72±0．67）×109／L，t=-2．422，P=0．019]。流式细胞检测结果显示，两组间外周血淋巴细胞、单核细胞和中性粒细胞上CD55平均荧光强度无变化（t=-0．965，-0．259，-0．571；P=0．340，0．797，0．571），CD59平均荧光强度差异无统计学意义（t=-1．031，-1．439，-0．765；P=0．307，0．156，0．447）。结论独立于降压作用之外，钙拮抗剂可能上调了2型糖尿病大血管病变患者外周血淋巴细胞CD55和CD59的表达。

Objective To investigate the effects of calcium antagonist on complement regulatory proteins CD55 and CD59 expression in peripheral blood leucocytes of patients with type 2 diabetes and macrovascular diseases. Methods Fifty - six patients with type 2 diabetes and macrovascular diseases were divided into two groups based on with or without calcium antagonist using： 22 patients have taken either amlodipine （12/22） or nifedipine （10/22） （calcium antagonist group）, and 34 patients did not have any history of calcium antagonist using（ controls group）. Venous blood samples were drawn from patients after an overnight fast. Plasma glucose and serum lipids were measured by routine methods. Mean fluorescence intensity （MFI） of CD55 and CD59 expression in peripheral blood leucocyte subsets （lymphocytes, monocytes and neutrophils） was studied using flow cytometry. Ultrasound imaging and offline Carotid artery intimamedia thickness （CIMT） image analysis were performed. Results There were no significant differences in gender, age, duration of illness, body mass index, waist - to - hip rate, fasting plasma glucose, HbAlc, fasting C peptide, serum lipids, blood pressure, CIMT, hs - CRP, neutrophils and monocytes between the two groups. In controls group, lymphocyte was higher than that of group calcium antagonist [ （2.05 ±0.66）× 10^9/L vs （1.72 ±0.67） ×10^9/L, t = -2. 422, P =0. 019]. Flow cytometrie analysis showed that there was no significant diffierence in MFI of CD55 expression in peripheral blood leucocyte subsets between the two groups （ t = - 0. 965, - 0. 259, - 0. 571 ; P = 0. 340,0. 797, 0. 571 ） , and MFI of CD59 expression was similar（t = -1.031, -1.439, -0.765; P = 0. 307, 0. 156, 0. 447）. Conclusions Independent of the effects on blood pressure, calcium antagonist could increase levels of CD55 and CD59 expression in peripheral blood lymphocyte of patients with type 2 diabetes and macrovascular diseases.