糖尿病周围神经病变患者血清基质细胞衍生因子-1α水平改变及鼠神经生长因子对其影响的研究

The changes of serum stromal cell-derived factor-1α in patients with diabetic peripheral neuropathy and the influence of mouse nerve growth factor

目的探讨糖尿病周围神经病变(DPN)患者血清基质细胞衍生因子-1α(SDF-1α)水平改变及鼠神经生长因子(MNGF)对其影响。方法选取T2DM患者180例,根据有无DPN分为DPN组92例和T2DM未合并DPN(T2DM)组88例。另选同期体检健康者90名作为健康对照(NC)组。将DPN组进一步分为MNGF治疗(A)亚组47例和基础治疗(B)亚组45例。检测各组血清SDF-1α水平,分析其与超氧化物歧化酶(SOD)、转化生长因子-β1(TGF-β1)、高敏C反应蛋白(hsC-RP)、神经生长相关蛋白-43(GAP-43)的关系。观察MNGF治疗前后两亚组血清SDF-1α水平的变化。结果血清SDF-1α水平由低到高依次为NC、DPN、T2DM组[(0.91±0.37)vs(1.71±0.43)vs(2.58±0.58)μg/L,P<0.05或P<0.01]。Pearson相关性分析结果显示,T2DM组血清SDF-1α水平与FPG、HbA1c、TGF-β1和hsC-RP呈正相关,与SOD呈负相关;DPN组血清SDF-1α水平与TG、TGF-β1呈正相关,与病程、FPG、HbA1c、SOD、hsC-RP、GAP-43、正中神经运动神经传导速度(MMCV)、腓总神经运动神经传导速度(PMCV)、正中神经感觉神经传导速度(MSCV)、腓总神经感觉神经传导速度(PSCV)呈负相关。A亚组血清SDF-1α水平治疗后较治疗前升高[(1.75±0.39)vs(2.09±0.45)μg/L,P<0.05],B亚组治疗后与治疗前比较差异无统计学意义[(1.67±0.48)vs(1.71±0.51)μg/L,P>0.05]。多元逐步回归分析结果显示,HbA1c、hsC-RP和腓总神经感觉神经传导速度(PSCV)是SDF-1α的影响因素。结论 DPN患者SDF-1α水平较T2DM患者低,MNGF增加血清SDF-1α水平。

Objective To investigate the changes of serum stromal cell-derived factor-1α（SDF-1α）in patients with diabetic peripheral neuropathy（DPN）and the influence of mouse never growth factor（MNGF）on the levels of serum SDF-1α. Methods 180 patients with type 2diabetes（T2DM）were divided into T2 DM with DPN（DPN group,n=92）and T2 DM without DPN（T2DM group,n=88）.90 healthy people were select as normal control（NC group）.DPN group was divided into 47 cases of MNGF treatment（A）subgroup and 45 cases of basic treatment（B）subgroup.The levels of serum SDF-1αwere measured using ELISA method.The relationships between the levels of serum SDF-1αand SOD,TGF-β1,hsC-RP,and GAP-43 were analyzed.After treatment,the levels of serum SDF-1αin A and B subgroups were compared. Results Compared with NC group[（0.91±0.37）μg/L],the levels of serum SDF-1αin T2 DM and DPN group were higher[（2.58±0.58）μg/L and（1.71±0.43）μg/L,respectively,P〈0.05 or P〈0.01].The levels of SDF-1αwere positively correlated with FPG,HbA1 c,TGF-β1and hsC-RP,and negatively correlated with SOD in T2 DM group.The levels of SDF-1αwere positively correlated with TG and TGF-β1,and negatively correlated with course of disease,FPG,HbA1 c,SOD,hsC-RP,GAP-43,MMCV,PMCV,MSCV and PSCV in DPN group.SDF-1αlevels were significantly increased after treatment with MNGF in subgroup A [（1.75±0.39）vs（2.09±0.45）μg/L,P〈0.05].There were no significant difference of SDF-1αlevels after treatment in subgroup B [（1.67±0.48）vs（1.71±0.51）μg/L,P〉0.05].Multiple stepwise regression analysis showed that HbA1 c,hsC-RP and PSCV were the independent factors related with the levels of SDF-1αin DPN patients. Conclusion The levels of serum SDF-1αin DPN patients are lower than in T2 DM patients without DPN.MNGF may increase the level of serum SDF-1α.