sEPCR、hs-CRP、TNF-α及IL-18水平与2型糖尿病患者大血管病变的相关性分析

摘要

Objective To explore the correlation of soluble endothelial cellular protein C receptor (sEPCR), high sensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α) and interleukin-18 (IL-18) levels with macroangiopathy in type 2 diabetic mellitus (T2DM) patients. Method 124 cases of T2DM patients treated in our hospital from October 2015 to June 2016 were selected as the research subjects. According to the presence of macroangiopathy, they were divided into macroangiopathy group (57 cases) and non-macroangiopathy group (67 cases). 60 cases of healthy physical examination during the same period in our hospital were included in control group. The levels of fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), sEPCR, hs-CRP, TNF-α and IL-18 levels in the three groups of subjects were detected. Analysis of the correlation between sEPCR, hs-CRP, TNF-α, IL-18 and macroangiopathy in T2DM patients. Result The levels of serum IL-18, sEPCR, TNF-α, hs-CRP, FBG and HbA1c in macroangiopathy group and non-macroangiopathy group were significantly higher than those in control group (P<0.05), the above indexes of macroangiopathy group were significantly higher than non-macroangiopathy group (P < 0.05). sEPCR ≥ 0.5 ng/ml, hs-CRP ≥ 5 mg/L, TNF-α ≥ 1.5 ng/ml, IL-18 ≥ 100 pg/ml were the independent risk factors of macroan-giopathy in patients with T2DM (P < 0.05). Conclusion IL-18, sEPCR, TNF-α and hs-CRP are closely related to the occurrence of macroangiopathy in T2DM patients, which can be used as an indicator of early clinical screening.%目的 分析可溶性内皮细胞蛋白C受体(soluble endothelialcell protein C receptor,sEPCR)、高敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)及白介素-18(interleukin-18,IL-18)与2型糖尿病患者大血管病变的相关性.方法 选取本院2015年10月至2016年6月收治的2型糖尿病患者124例为研究对象,根据有无大血管病变将入选患者分为大血管病变组(57例)和无大血管病变组(67例).另选取同期本院健康体检者60例纳入对照组.检测三组研究对象空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(hemoglobin A1c, HbA1c)、sEPCR、hs-CRP、TNF-α及IL-18水平,分析sEPCR、hs-CRP、TNF-α、IL-18与2型糖尿病患者大血管病变的相关性.结果 大血管病变组和无大血管病变组患者的血清IL-18、sEPCR、TNF-α、hs-CRP、FBG、HbA1c水平均显著高于对照组(P<0.05),且大血管病变组患者上述指标水平均显著高于无大血管病变组(P<0.05).多因素Logistic回归分析显示,sEPCR水平≥0.5 ng/ml、hs-CRP水平≥5 mg/L、TNF-α水平≥1.5 ng/ml、IL-18水平≥100 pg/ml均为2型糖尿病合并大血管病变的独立危险因素(P<0.05).结论 IL-18、sEPCR、TNF-α及hs-CRP与2型糖尿病患者大血管病变的发生密切相关,可作为临床早期筛查指标.