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目的观察2型糖尿病患者血清炎症因子水平的变化,探讨炎症因子对2型糖尿病尤其老年患者合并心脑血管病变的影响。方法 103例2型糖尿病患者按年龄及是否合并心脑血管病变分别分组。用自动生化分析仪测定所有患者血清高敏C反应蛋白(hsC-RP)、FBG、HbA1c、TC、TG、LDL-C水平,用EL-ISA方法测定血清白介素6(IL-6)和肿瘤坏死因子α(TNF-α)水平。结果 (1)2型糖尿病患者年龄≥65岁者,血清hsCRP、TNF-α、IL-6水平均高于年龄<65岁者(P<0.01)。(2)合并心脑血管病变者,血清hsC-RP水平较高于无心脑血管病变者(P<0.05)。年龄≥65岁中合并心脑血管病变者,血清hsC-RP水平高于无心脑血管病变者(P<0.05)。(3)血清hsCRP水平与年龄和血清TG水平呈正相关(r=0.257,P<0.01;r=0.220,P<0.01)。影响hsC-RP的因素主要为年龄,回归方程为y(hsC-RP)=2.407+0.100年龄。(4)2型糖尿病中≥65岁者合并心脑血管病变的发生率高于<65岁者(P<0.01)。结论 hsC-RP与大血管病变相关,但IL-6和TNF-α与大血管病变无明显相关性;年龄增长是血清hsC-RP水平升高的主要影响因素。
Objective To investigate the changes of serum inflammatory cytokines in type 2 diabetes mellitus (T2DM) and to explore the effect of inflammatory cytokines on the cardiovascular and cerebrovascular diseases in type 2 diabetic patients, especially elderly patients. Methods A total of 103 patients with type 2 diabetes were divided into groups according to their age and whether they had combined cardiovascular and cerebrovascular diseases. Serum levels of high-sensitivity C-reactive protein (hsC-RP), FBG, HbA1c, TC, TG and LDL-C in all patients were measured by automated biochemical analyzer. Serum levels of interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) levels. Results (1) Serum levels of hsCRP, TNF-α and IL-6 in type 2 diabetic patients were higher than those of patients <65 years of age (P <0.01). (2) In patients with cardiovascular and cerebrovascular diseases, serum hsC-RP levels were higher than those without cardiovascular and cerebrovascular diseases (P <0.05). Patients with age ≥ 65 years with cardiovascular disease, serum hsC-RP levels were higher than those without cardiovascular disease (P <0.05). (3) Serum hsCRP level was positively correlated with age and serum TG level (r = 0.257, P <0.01; r = 0.220, P <0.01). The main factors affecting hsC-RP were age, the regression equation was y (hsC-RP) = 2.407 +0.100 years. (4) The incidence of cardiovascular and cerebrovascular diseases in patients with type 2 diabetes ≥ 65 years was higher than that of patients <65 years old (P <0.01). Conclusions There is a correlation between hsC-RP and macroangiopathy. However, there is no significant correlation between hsC-RP and macrovascular disease. Age is the main factor influencing the level of serum hsC-RP.