高原地区糖尿病下肢动脉血管病变患者的血清氧化应激及炎性因子水平变化

Changes of serum oxidative stress and inflammatory factors in patients with diabetic lower extremity arterial disease at high altitude

目的:探讨高原地区糖尿病下肢动脉血管病变患者的血清氧化应激及炎性因子水平变化情况。方法:选取215例2型糖尿病患者为研究对象,根据下肢血管彩色多普勒超声检查结果将其分为合并下肢动脉血管病组(观察组,n=120)与不合并下肢动脉血管病组(对照组,n=95)。比较两组患者临床资料、糖脂代谢指标、氧化应激指标及炎性因子表达水平。结果:两组患者年龄、性别、腰围、BMI指数、DBP、SBP比较,差异无统计学意义(P>0.05);观察组患者糖尿病病程长于对照组(P<0.05)。观察组患者FBG、HbA1c、LDL-C高于对照组(P<0.05),HDL-C低于对照组(P<0.05),两组患者TC、TG比较,差异无统计学意义(P>0.05)。观察组患者外周血SOD及CAT水平低于对照组,MDA水平高于对照组(P<0.05)。观察组患者外周血IL-6、TNF-α、CRP表达水平均高于对照组(P<0.05)。结论:相较于单纯2型糖尿病患者,合并下肢动脉血管病变患者的外周血炎性因子(IL-6、TNF-α、CRP)水平升高,氧化应激指标(MDA、CAT、SOD)异常,提示上述指标可能参与了2型糖尿病患者血管病变的病理生理过程。

Objective:To investigate the changes of serum oxidative stress and inflammatory factors in patients with diabetic lower extremity arterial disease at high altitude.Methods:In this study,215 patients with type 2 diabetes mellitus were selected as subjects.According to the results of color Doppler ultrasonography of lower extremity blood vessels,they were divided into two groups:the observation group(n=120)with lower extremity arterial vascular disease and the non-lower extremity arterial vascular disease group(control group,n=95).The clinical data,glycolipid metabolism,oxidative stress and expression of inflammatory factors were compared between the two groups.Results:There was no significant difference in age,sex,waist circumference,BMI index,DBP and SBP between the two groups(P>0.05),the duration of diabetes in the observation group was longer than that in the control group(P<0.05).The FBG,HbA1c and LDL-C in the observation group were higher than those in the control group(P<0.05),and HDL-C was lower than those in the control group(P<0.05).There was no significant difference in TC and TG between the two groups(P>0.05).The levels of SOD and CAT in peripheral blood of patients in the observation group were lower than those in the control group,and the levels of MDA in the observation group were higher than those in the control group(P<0.05).The expression levels of IL-6,TNF-αand CRP in peripheral blood of patients in observation group were higher than those in control group(P<0.05).Conclusion:Compared with type 2 diabetes mellitus,the levels of inflammatory factors(IL-6,TNF-α,CRP)in peripheral blood of patients with lower extremity arterial disease increased,and oxidative stress indicators(MDA,CAT,SOD)were abnormal,suggesting that they may participate in the pathophysiological process of type 2 diabetic vascular disease.