2型糖尿病患者血清sICAM-1和sVCAM-1的检测与大血管病变的关系

Serum concentration of soluble intercellar adhesion molecule-1 and soluble vasucular cell adhesion molecule-1 are related to macroangiopathy in patients with type 2 diabetes mellitus

目的 探讨 2型糖尿病患者血清可溶性细胞间黏附分子 1(solubleintercellaradhesionmolecule 1,sICAM 1)和可溶性血管细胞黏附分子 1(solublevascularcelladhesionmolecule 1,sVCAM 1)与大血管病变的关系。方法 测定 76例 2型糖尿病患者及 4 8例健康对照者血清sICAM 1和sVCAM 1水平 ,76例 2型糖尿病患者分为大血管病变组 (2 8例 )与无大血管病变组 (48例 ) ,比较三组间sICAM 1和sVCAM 1的水平。并对糖尿病组中颈总动脉内膜厚度 (intima mediathickness,IMT)与sICAM 1和sVCAM 1作单因素相关分析。结果 2型糖尿病患者中无大血管病变组及有大血管病变组的血清sICAM 1和sVCAM 1水平分别高于健康对照者 (P <0 .0 5 ,P <0 .0 1) ,有大血管病变者又高于无大血管病变者 (P <0 .0 5 )。糖尿病组中颈总动脉IMT分别与sICAM 1和sVCAM 1呈正相关 (r =0 .2 0 2 ,P <0 .0 5 ;r =0 .35 8,P <0 .0 1)。结论 2型糖尿病患者血清sICAM 1和sVCAM 1水平的升高 ,表明了体内存在血管内皮细胞功能紊乱和白细胞的激活 ,并参与了大血管病变的发生发展过程 。

Objective To investigate the relationship between serum concentration of soluble intercellar adhesion molecule 1(sICAM 1),soluble vascular cell adhesion molecule 1(sVCAM 1) and macroangiopathy in type 2 diabetes. Methods Serum concentration of sICAM 1 and sVCAM 1 in type 2 diabetic patients (n76) and controls (n=48) was measured,and the diabetic patients were divided into two groups: with(n=28) and without(n=48) macroangiopathy, the sICAM 1 and sVCAM 1 levels were compared among three groups, and also the association of sICAM 1,sVCAM 1 levels and common carotid artery intima media thickness(IMT) were analyzed. Results The serum concentrations of sICAM 1 and sVCAM 1 were higher in diabetic patients without and with macroangiopathy than those of the controls (P< 0.05 ,P< 0.01 ),and the levels were higher in diabetes with macroangiopathy than without(P< 0.05 ). In diabetes groups, sICAM 1 and sVCAM 1 levels were related to IMT (r= 0.202 ,P< 0.05 ; r= 0.358 ,P< 0.01 ).Conclusion Increasing serum level of sICAM 1and sVCAM 1 in type 2 diabetic patients indicates vascular endothelial cells disordering and leukocyte activating,and the processis involved in the progression of macroangiopathy, and sICAM 1 and sVCAM 1 levels can act as a serum indicator in monitoring the pathography.