摘要
目的:探讨半胱氨酸蛋白酶抑制剂C(cystatin C,Cys C)与下肢静脉性溃疡(venous leg ulceration,VLU)发生的相关性。方法:采用酶联免疫吸附法(ELISA法)对下肢慢性静脉功能不全(chronic venous insufficiency,CVI)无溃疡患者、VLU患者和正常人的血浆肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素(interleukin,IL)-1β、IL-2受体(IL-2 receptor,IL-2R)、CysC水平及静脉组织Cys C水平进行检测。结果 :①VLU组血浆TNF-α、IL-1β水平分别为(185.46±20.90)pmol/L和(100.60±17.43)pmol/L,明显高于对照组的(32.28±7.76)pmol/L和(58.72±16.20)pmol/L(P<0.05),CVI无溃疡组的TNF-α和IL-1β分别为(41.68±7.35)pmol/L和(65.36±25.51)pmol/L,与对照组相比差异无统计学意义(P>0.05);VLU组和CVI无溃疡组血浆IL-2R水平分别为(138.56±78.75)pmol/L和(94.45±35.26)pmol/L,与对照组的(93.67±12.28)pmol/L相比较,差异无统计学意义(P>0.05);②VLU患者组织Cys C表达较单纯CVI无溃疡患者和正常人明显降低(P<0.05);手术前VLU患者血浆Cys C的表达显著低于正常人(P<0.05),手术后4 d VLU患者血浆Cys C的表达显著高于手术前(P<0.05)。③相关分析显示Cys C表达与TNF-α和IL-1β表达呈显著负相关,r值分别为-0.878和-0.990(P<0.05)。④术后Cys C表达较低的患者溃疡复发率高于Cys C高表达患者。结论:Cys C的表达与VLU的发病有密切关系,Cys C的低表达可能是导致VLU的发病和复发的重要因素。
Objective：To investigate the relationship between serum levels of cystatin C （Cys C）and and venous leg ulceration （VLU）. Methods：Subjects were divided into three groups,chronic venous insufficiency （CVI） patients without ulcers, patients with VLU and normal subjects. Enzyme-linked immunosorbent assay（ELISA） was used for detection of plasma TNF-a, IL-1β, IL-2R, Cys C levels and Cys C level of venous tissue. Results： （1） The plasma levels of TNF-a and IL-1β in the VLU patients with venous ulcers were（ 185.46 ± 20.90） pmol/L and（100.60 ± 17.43） pmol/L respectively, and was significantly higher than those in the control group [（32.28 ± 7.76） pmol/L of TNF-oL and （58.72± 16.20） pmol/L of IL-1β] （P 〈 0.05）. The plasma levels of TNF-a and IL-1β in the CVI without ulcers group were（41.68 ± 7.35） pmol/L and（65.36 ± 25.51） pmol/L,and had no significant difference compared to the control group （P 〉 0.05）;The plasma IL-2R levels in the VLU group and CVI without ulcers group were （β8.56 ± 78.75） pmol/L and（94.45 ± 35.26） pmol/L,and both of them had no significant difference compared to the control group[ （93.67 ±12.28） pmol/L] （P 〉 0.05）; （2）Cys C expression in venous tissue was significantly lower in VLU patients than in the CVI without ulcers and control group（P 〈 0.05）;The plasma Cys C level of VLU group was significantly lower than that of control before surgery （P 〈 0.05）,and the plasma Cys C level of VLU group four days after surgery was significantly higher than that before surgery （P 〈 0.05）. （3） The correlation analysis showed that Cys C expression was significantly negatively correlated with expressions of TNF-a and IL-1β（r = -0.878 and -0.990,P 〈0.05）. （4）After surgery,ulcer recurrence rate in patients with low expression of Cys C were higher than that with the high Cys C expression. Conclusion：Cys C expression is closely related to the incidence of VLU. Low expression of the Cys C may be an important factor of the incidence and recurrence of VLU.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2012年第7期960-964,共5页
Journal of Nanjing Medical University(Natural Sciences)
基金
江苏省人才高峰项目(303070470IB09)
