2型糖尿病患者血清炎性因子与颈动脉粥样硬化的相关性研究

Correlation between serum inflammatory factors and carotid atherosclerosis in patients with type 2diabetes

目的研究2型糖尿病患者血清炎性因子水平与颈动脉粥样硬化的关系。方法选择124例2型糖尿病患者,采用酶联免疫吸附法测定血清内皮细胞黏附分子1(ICAM-1)、血管细胞黏附分子1(VCAM-1)、E选择素、白细胞介素6(IL-6)和C反应蛋白(CRP)水平;按颈动脉超声检查结果将糖尿病患者分为颈动脉正常组(38例)、颈动脉增厚组(40例)和颈动脉斑块组(46例)。选择40例健康体检者作为对照组,比较各组血清炎性因子水平。结果①颈动脉正常组血清ICAM-1、IL-6及CRP较对照组升高,颈动脉增厚组ICAM-1、VCAM-1、IL-6及CRP水平高于颈动脉正常组,颈动脉斑块组ICAM-1、VCAM-1、E选择素高于颈动脉增厚组,上述指标各组差异均有统计学意义,P<0.05,或P<0.01。②相关性分析显示,颈动脉内-中膜厚度(IMT)增厚程度与糖化血红蛋白(HbAlc)(r=0.472)、ICAM-1(r=0.501)、VCAM-1(r=0.484)、E选择素(r=0.289)、IL-6(r=0.425)及CRP(r=0.381)呈正相关。患者HbAlc与ICAM-1、VCAM-1、IL-6及CRP呈正相关。ICAM-1、VCAM-1、E选择素、IL-6、CRP间呈正相关,均P<0.01或P<0.05。结论炎性反应参与了2型糖尿病患者颈动脉粥样硬化的发病过程,血清炎性因子水平可以在一定程度上反映糖尿病患者的颈动脉粥样硬化程度。

Objective To study the correlation between serum inflammatory factors and carotid atherosclerosis in patients with type 2 diabetes. Methods A total of 124 patients with type 2 diabetes were collected in the study. The levels of serum intercelluar adhesion molecule-1 （ ICAM-1 ） , vascular cell adhesion molecular-1 （VCAM-1）, E-selectin, interleukin-6 （IL-6） and C reactive protein （CRP） were measured with enzyme-linked immunosorbent assay （ELISA）. The patients with diabetes were divided into normal carotid, carotid thickening and carotid plaque groups according to the findings of carotid ultrasound. Forty healthy subjects were used as controls. The levels of serum inflammatory factors were compared in each group. Results （1）The levels of serum ICAM-1, IL-6 and CRP in the normal carotid group were higher than those in the control group. The levels of ICAM-1, YCAM-1, IL-6 and CRP in the carotid thick- ening group were higher than those in the normal carotid group. The levels of ICAM-1, VCAM-1 and E-selectin in the carotid plaque group were higher than those in the carotid thickening group. There were significant differences in the above indicators among each group （ P 〈 0. 05 or P 〈 0.01 ）. （2）Correlation analysis showed that the severity of carotid intima-thickness was positively correlated with HbAlc （r = 0. 472）,ICAM-1 （ r = 0. 501 ）, VCAM-1 （ r = 0. 484）, E-selectin （ r = 0. 289）, IL-6 （ r = 0. 425 ） and CRP （ r = 0. 381 ）. The correlation of HbAlc in patients was positively correlated with ICAM-1, VCAM-1, IL-6, and CRP. There was positive correlation among ICAM-1, VCAM-1, E-selectin, IL-6 and CRP （ all P 〈0. 01 or P 〈 0.05）. Conclusions The inflammatory response participated in the process of the occurrence of carotid atherosclerosis in patients with type 2 diabetes, and the levels of serum inflammatory factors may reflect the severity of carotid atherosclerosis to some extent in patients with diabetes.