摘要
目的探讨肿瘤坏死因子-α(TNF-α)和白介素(IL)-6在2型糖尿病(T2DM)大血管病变中的预测价值。方法选取无糖尿病并发症的T2DM患者215例为试验组(T2DM组),健康献血者112例为对照组。两组受试者入选初始及追踪随访过程中每年检测血清TNF-α、IL-6和糖化血红蛋白(HbA1c)水平,每年测定颈动脉内膜中层厚度,进行下肢动脉彩超、头CT和心电图检查。电化学发光法测定TNF-α和IL-6。结果(1)两组受试者大血管病变发生率间差别有统计学意义(P<0.01)。(2)两组发生动脉粥样硬化者TNF-α和IL-6水平均呈逐年上升,但两组间TNF-α和IL-6水平比较,差别无统计学意义(P>0.05)。(3)两组发生动脉粥样硬化者TNF-α和IL-6水平与未发生动脉粥样硬化者比较,差别有统计学意义(P<0.05)。(4)将T2DM组按HbA1c水平再分成4组,发现不同水平范围的HbA1c组,TNF-α和IL-6水平间差别无统计学意义(P>0.05)。结论(1)炎性细胞因子TNF-α和IL-6水平的增高可预测糖尿病大血管病变的发生,但与非糖尿病者相比并无特异性价值。(2)炎性机制并非糖尿病者比非糖尿病者大血管病变发生早、进展快、预后差的原因。(3)高血糖加速动脉粥样硬化形成的原因之一是诱导炎性细胞的激活,从而促使炎性因子释放增加,但并无量效相关性。
Objective To explore the predictive value of TNF - α and IL - 6 in the incidence of type 2 diabetes （T2DM） macrovascular complication. Methods All participants were divided into T2DM group （215 cases） and control group （ 112 healthy blood donors）. TNF - α and IL -6 were analyzed in electro - chemical luminescence method. Every year, all par- ticipants received various examinations, including examination of intima of carotid artery and lower limb arterial ultrasonic, computerized tomographic scanning of cranium and electrocardiography. Results （ 1 ） The incidence rate of macrovascular atherosclerosis was significantly higher in T2DM group than that in the control group （ P 〈0.01 ）. （2） The levels of TNF - α and IL - 6 in those with atherosclerosis increased year by year in both groups; But there was no significant difference in levels of TNF - α and IL - 6 between two groups （ P 〉 0. 05 ）. （ 3 ） Significant difference Was found in levels of TNF - α and IL - 6 between patients with atherosclerosis and those without atherosclerosis （ P 〈 0. 05 ）. Conclusion The elevated levels of TNF - α and IL -6 predict the incidence of type 2 diabetes macrovascular complication. But no evidence can be found to prove the existence of specific inflammation mechanism in type 2 diabetes macrovascular complication. Inflammation mechanism is not the reason for earlier occurrence, faster progress and worse prognosis of diabetes macrovascular complication in patients with diabetes than healthy persons. One of the reasons why hyperglycemia causes atherosclrosis is the activation of induction inflammatory cell to make inflammatory factors discharge, but there is not any quantity - effect correlation.
出处
《中国全科医学》
CAS
CSCD
2007年第20期1678-1680,共3页
Chinese General Practice
基金
黑龙江省教育厅项目(10551203)
