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冠心病合并2型糖尿病患者内皮细胞微粒水平检测及临床意义

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DOI:
作者:
蒋红丽
jianghongli
作者单位:
新华医院
xinhua hospital
关键词:
内皮细胞微粒, 内皮功能评估, 冠心病, 糖尿病
endothelial microparticle, endothelium function evaluation, coronary artery disease, diabetes mellitus
摘要:
目的：探讨冠心病合并2型糖尿病患者血浆内皮细胞微粒水平与单纯冠心病患者及健康个体检测差异。 方法：招募单纯冠心病患者（A组）78例，冠心病合并糖尿病患者（B组）96例，健康个体（C组）30例。生化法检测受试者血脂水平，流式微球技术检测血浆内皮细胞微粒水平，ELISA方法检查内皮素-1和细胞间粘附分子-1水平，并对所有冠心病患者（A组和B族）Gensini评分。统计比较各组间血脂水平、内皮细胞微粒及内皮素-1和细胞间粘附分子-1水平差异，分析A组与B组患者间Gensini评分的差异。 结果：单纯冠心病患者（A组）较健康对照组个体（C组）血脂水平无显著性差异。B组患者TG水平显著性高于A组和C组个体，HDL-C亦显著性低于A组和C组个体。冠心病患者（A组和B组）较健康个体（C组）血浆内皮细胞微粒水平、血清ET-1和ICAM-1水平显著升高。冠心病合并II型糖尿病患者Gensini评分显著性高于单纯冠心病（P<0.01）。 结论：冠心病患者存在一定程度的血管内皮功能异常，高血糖和胰岛素抵抗增加了其血管内皮损伤程度。检测血浆内皮细胞微粒水平可为内皮功能的检测提供新的方法。
Object: to evaluate the difference of circulatory endothelial microparticle between the coronary artery disease (CAD) patients with the patients with CAD and type II DM. Methods: We have enrolled the 78 CAD patients without hypertension and DM (A group), 96 patients (B group) both with CAD and type II DM and 30 healthy subjects (C group). The lipid profile of the participants was detected by biochemistry method. The level of endothelial microparticle was determined by the novel cytometry bead assay, and the levels of ET-1 and ICAM-1 were tested by ELISA method. We analyzed the difference of lipid profile, EMP, ET-1, ICAM-1 and Gensini score between the groups. Results: The patients with both of CAD and type II DM have higher level of TG and lower HDL-C than the patients of A group and healthy control. There is no statistical difference between A group and C group. Both A and B group acquire the higher level of EMP, ET-1 and ICAM-1 than healthy controls. Additionally, the patients with CAD and DM have the higher level of EMP, ET-1 and ICAM-1 than the CAD patients without hypertension and DM, so does the Gensini score. Conclusion: CAD patients suffer from the endothelial dysfunction. The disturbance of glucose metabolism and insulin resistance deteriorate the situation. The determination of circulatory EMP level by cytometry bead assay provides one new way to evaluate the severity of the endothelial dysfunction.

 

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