【摘要】 目的观察老年2型糖尿病(T2DM)患者体内内皮祖细胞(EPCs)的功能(以黏附细胞数表示为TNE-A)及其数量(以外周血计数表示为TNE),探讨其在老年T2DM发生发展中的作用。方法选择老年T2DM患者30例和老年正常对照10例,密度梯度离心法从外周血获取单个核细胞,接种在培养板内,培养7 d后对贴壁细胞进行测定;流式细胞仪鉴定FITC标记荆豆凝血素Ⅰ(FITC-UEA-I)和Di I标记的乙酰化低密度脂蛋白(Di I-ac LDL)双阳性细胞为正常分化的EPCs;胰蛋白酶消化后计数贴壁细胞观察TNE-A计数。同时采用流式细胞仪测定外周血TNE计数。结果1老年T2DM患者EPCs的TNE-A较正常对照组显著减少,并且血管病变组间也有差异(t=2.185、2.099;P<0.05)。外周血TNE较正常对照组减低(t=2.179;P<0.05),但血管病变各组间无差异(t=1.857;P>0.05)。2随血糖及糖化血红蛋白(Hb A1c)升高,T2DM老年患者TNE-A以及TNE计数逐渐降低(t=2.872、2.855、2.985、2.861;P<0.01),组间有统计学差异(t=2.122、2.103、2.105、2.175;P<0.05)。3Spearman相关分析显示,TNE-A水平与低密度脂蛋白(LDL)、舒张压(SBP)、2 h餐后血糖(2 h PBG)、Hb A1c呈负相关(r分别为-0.40、-0.39、-0.21、-0.24,P<0.01或<0.05)。而外周血TNE与空腹血糖(FBG)、Hb A1c呈负相关(r分别为-0.231、-0.267,P<0.05)。4以T2DM为整体,有血管病变为因变量(有=1,无=0),以年龄等危险因素为自变量,进行Logistic回归分析,SBP、TNE-A进入回归方程。结论 T2DM老年患者EPCs的黏附功能明显受损,与其血管病变关系较大;而外周血EPCs数目与血管病变关系较小,EPCs生物学功能仍需进一步研究。更多还原

【Abstract】 Objective To investigate the clinical significance of endothelial progenitor cells( EPCs) from the older type 2 diabetes mellium( T2DM) patients by the mumbles of EPCs in peripheral blood( TNE) and the adherent mumbles of EPCs cells( TNE-A).Methods EPCs isolated from human peripheral blood of the older T2 DM patient( n = 30) and age matched control subjects( n = 10).Cytochemical analysis was conducted after 7 days culture.EPCs were characterized as Dil-ac LDL / FITC-UEA-1 double positive cell detected by FCM.EPCs adhesion assay was performed by replacing those on fibronectin-coated dishes.Then TNE-A was counted.TNE in peripheral blood wass detected by FCM.Results TNE-A was significantly impaired in older T2 DM group compared with control group( t = 2.185,2.099;P < 0.05).TNE was deceased in older T2 DM patient( t = 2.179,P < 0.05).TNE-A and TNE were decreased significantly( t = 2.872,2.855,2.985,2.861;P < 0.01) than those of control group and were also different with the increase of the glucose and Hb Alc( P < 0.05).There were negative correlation between TNE-A and LDL,SBP,2h PBG,Hb Alc and too negative correlation between TNE and FBG,Hb Alc( P < 0.05) by Spearman relative analysis.The SBP and TNE-A were valuable by Logistic regressive analysis.Conclusions These findings suggest adhesion function of EPCs may be play an important role in the development of DM.EPCs dysfunction need be further investigated.更多还原