2型糖尿病视网膜病变患者血清sICAM-1、sVCAM-1变化及临床意义.docVIP

2型糖尿病视网膜病变患者血清sICAM-1、sVCAM-1变化及临床意义 　　摘 要 目的：探讨血清可溶性细胞间黏附分子-1(sICAM-1)及可溶性血管细胞黏附分子-1(sVCAM-1)与2型糖尿病视网膜病变的关系。方法：测定15例健康对照者，18例2型糖尿病无DR患者(NDR组)，27例2型糖尿病伴背景型视网膜病变者(BDR组)，及25例2型糖尿病伴增生型视网膜病变者(PDR组)血清sICAM-1、sVCAM-1水平。结果：sICAM-1血清含量在正常对照组及NDR组、BDR组、PDR组浓度依次增高，且两两比较差别有显著性(?P?＜0.05)；sVCAM-1血清含量在糖尿病各组均高于正常对照组，差别有统计学意义(?P?＜0.05)；在BDR组、PDR组均高于NDR组，(?P?＜0.05)；但BDR组、PDR组间比较，差别不显著(?P?＞0.05)。结论：sICAM-1和sVCAM-1可能参与了2型糖尿病视网膜病变的发病，可作为视网膜病变发生的预测及监测指标。? 　　关键词 2型糖尿病视网膜病变 sICAM-1 sVCAM-1? 　　doi:10.3969/j.issn.1007-614x.2012.06.254?? 　　Abstract Objects:To investigate the relationship of serum soluble intercellular adhesion molecule-1(sICAM-1) and soluble vascular cell adhesion molecule-1(sVCAM-1) in patients with type 2 diabetes mellitus with diabetic retinopathy.Methods:Serum levels of sICAM-1 and sVCAM-1 were measured with ELISA in 18 cases of type 2 diabetes without DR(NDR group),27 cases of type 2 diabetes with background diabetic retinopathy(BDR group),25 cases with proliferated diabetic retinopathy(PDR group)and 15 cases of healthy subjects.Results:sICAM-1 serum levels in normal control group and NDR group,BDR group,PDR group were increased,and pairwise comparisons were significantly different(?P?＜0.05);sVCAM-1 serum levels in the diabetic group were higher than those in normal control group,the difference was statistically significant(?P?＜0.05);sVCAM-1 serum levels in the BDR group and PDR group were higher than those in the NDR group(?P?＜0.05);but when BDR group,PDR groups were compared,the difference was not significant(?P?＞0.05).Conclusions:sICAM-1 and sVCAM-1 may be involved in the pathogenesis of diabetic retinopathy,which can be regarded as prediction and monitoring indicators of DR.? 　　Key Words Diabetic retinopathy;sICAM-1;sVCAM-1 　　糖尿病视网膜病变(DR)是糖尿病常见的微血管并发症之一。近年来许多研究表明DR是一种慢性低度炎症病变，炎症尤其是白细胞到视网膜微血管的黏附，可能是???致DR复杂病理的起始和最终的共同途径［1］。细胞间黏附分子-1、血管细胞黏附分子-1作为重要的炎症因子在DR的发生发展中起重要作用。本研究通过观察2型糖尿病患者血清中其可溶性成分，即sICAM-1、sVCAM-1水平的变化，探讨其在DR发病机制中的作用及临床意义。 　　资料与方法 　　研究对象：选取2009年8月～2