摘要
目的观测2型糖尿病合并急性脑梗死(DACI)患者血清可溶性CD40配体(sCD40L)水平变化及颈动脉粥样硬化特点,探讨血清sCD40L水平与颈动脉易损斑块的相关性。方法本实验分为糖尿病合并急性脑梗死组(DACI组,n=69)、单纯糖尿病组(DM组,n=32)和健康对照组(NC组,n=28)。3组研究对象均应用酶联免疫法测量血清sCD40L的水平,常规生化检测空腹血糖(FBG)、血脂、糖化血红蛋白(HbA1c)。并行彩色多普勒检查,测定颈动脉内-中膜厚度(IMT)、有无斑块及计算Crouse积分。根据超声结果将DACI组分为稳定斑块组、不稳定斑块组。结果3组之间血清sCD40L水平、IMT、斑块检出率、Crouse积分差别有统计学意义(P<0.05)。DACI组以不稳定斑块为主,且不稳定斑块组血清sCD40L水平高于稳定斑块组(P<0.05)。相关分析显示,血清sCD40L水平与IMT(r=0.733,P<0.01)、Crouse积分(r=0.645,P<0.01)、HbA1c(r=0.272,P<0.05)、甘油三酯(r=0.276,P<0.05)均呈显著正相关。结论血清sCD40L促进2型糖尿病患者颈动脉粥样硬化,其水平升高可能反应颈动脉粥样斑块的不稳定性。
Objective To investigate the changes of serum concentrations of soluble CD40 ligand（sCD40L） and characteristics of carotid atherosclerosis in type 2 diabetics with acute cerebral infarction,and then to explore the relationship between serum soluble CD40 ligand and carotid plaque stability.Methods 69 patients of type 2 diabetes mellitus with acute cerebral infarction（DACI group）,32 subjects with simple type 2 diabetes mellitus（DM group）,and 28 normal controls（NC group）were included.Serum levels of soluble CD40 ligand（sCD40L） were measured by enzyme-linked immunosorbent assay（ELISA）.Fasting blood glucose,lipid,and glycohemoglobin A1c were detected.Intima-media thickness（IMT）,plaque echogenicity and morpholog were detected by duplex color doppler ultrasound and the Crouse score was calculated.DACI group was divided into the stable plaque subgroup and the unstable plaque subgroup according to ultrasound results.Results There were significant differences in sCD40L,IMT,the prevalence of carotid plaques and Crouse score among the three groups（P〈0.05）.Compared with NC group and DM group,DACI group mainly exhibited unstable plaques.Furthermore,serum sCD40L levels in patients with unstable plaques were higher than those with stable plaques（P〈0.05）.The level of serum sCD40L was positively related with IMT（r=0.733,P〈0.01）,Crouse score（r=0.645,P〈0.01）,HbA1c（r=0.272,P〈0.05）,and triglyceride（TG）（r=0.276,P〈0.05）.Conclusion Among type 2 diabetic patients,high-circulating sCD40L levels may promote carotid atherosclerosis and carotid plaque instability.
出处
《山东大学学报（医学版）》
CAS
北大核心
2010年第3期27-29,43,共4页
Journal of Shandong University:Health Sciences
关键词
2型糖尿病
脑梗死
CD40配体
颈动脉疾病
动脉硬化
Type 2 diabetes mellitus
Cerebral infarction
CD40 ligand
Carotid artery disease
Atherosclerosis
