【摘要】 目的研究血清sP-selectin、sE-selectin水平与糖尿病患者胰岛素抵抗的关系,进一步为临床工作提供依据。方法 120例糖尿病患者中的糖尿病前期患者40例,糖尿病合并冠心病患者40例,单纯糖尿病患者40例,同期健康查体的患者40例为对照组,通过收集整理4组患者血压、血糖水平(空腹血糖、糖化血红蛋白)以及血脂水平(胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇),比较4组患者之间空腹胰岛素、胰岛素抵抗指数以及可溶性P-选择素、可溶性E-选择素之间的相关性。结果糖尿病前期组、单纯糖尿病组、糖尿病合并冠心病组收缩压、空腹血糖、三酰甘油、胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹胰岛素、sP-selectin、sE-selectin水平均高于健康体检组,其中糖尿病合并冠心病组高于单纯糖尿病组,糖尿病组高于糖尿病前期组,差异均有统计学意义(P<0.05)。随着病情的加重患者胰岛素抵抗更为明显,分析血清中sP-selectin、sE-selectin水平发现,可溶性P-选择素水平与空腹血糖、空腹胰岛素、糖化血红蛋白、三酰甘油水平以及胰岛素抵抗指数呈正相关(r值分别为0.04、0.10、0.11、0.59、0.62,P<0.05);患者可溶性E-选择素水平与空腹血糖、空腹胰岛素、糖化血红蛋白、三酰甘油水平以及胰岛素抵抗指数呈正相关(r值分别为0.16、0.11、0.10、0.42、0.43,P<0.05),与高密度脂蛋白水平呈负相关(r=-0.21,P<0.05)。结论血清sP-selectin、sE-selectin水平与糖尿病患者体内胰岛素水平以及胰岛素抵抗之间具有一定的相关性,针对血清sP-selectin、sE-selectin水平与胰岛素抵抗的相关性需要进一步的研究,对于明确患者的病情以及发病机理具有更好的临床指导作用,值得临床上进一步研究发展。更多还原

【Abstract】 Objective To investigate the correlation between serum levels of sP-selectin,sE-selectin and insulin resistance in patients with diabetes mellitus in order to further provide the scientific basis for clinical treatment. Methods A total of 120 patients with diabetes mellitus who were treated in our hospital from January 2015 to January 2016 were enrolled in the study,including 40 patients with prediabetic state( prediabetic state group),40 patients with diabetes mellitus complicated by coronary heart disease( CHD)( diabetes + CHD group),40 patients with simple diabetes( simple diabetes group),at the same time,40 healthy subjects were served as control group. The levels of blood glucose including fasting plasma glucose and glycosylated hemoglobin and blood lipids including cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol were observed and compared among the four groups,moreover,the correlation among fasting insulin,insulin resistance index,soluble P-selectin and soluble E-selectin was analyzed and compared between the four groups. Results The levels of systolic pressure,blood glucose,triglyceride,cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,fasting insulin,sP-selectin and sE-select in prediabetic state group,simple diabetes group and diabetes+ CHD group were obviously higher than those in control group,moreover,which in diabetes + CHD group were significantly higher than those in simple diabetes group,besides,which in simple diabetes were significantly higher than those in prediabetic state group( P < 0. 05). The serum levels of sP-selectin were positively correlated with those of fasting blood glucose,fasting insulin,glycosylated hemoglobin,triglyceride and insulin resistance indexes( r = 0. 04,0. 10,0. 11,0. 59,0. 62,respectively,P < 0. 05). Moreover the levels of soluble E-selectin were positively correlated to those of fasting blood glucose,fasting insulin,glycosylated hemoglobin,triglyceride and insulin resistance indexes( r = 0. 16,0. 11,0. 10,0. 42,0. 43,respectively,P < 0. 05),however,which were negatively correlated with the levels of high density lipoprotein( r =-0. 21,P < 0. 05). Conclusion The serum levels of sP-selectin and sE-selectin are correlated with insulin levels and insulin resistance in patients with diabetes mellitus,which has a better clinical guidance effect in evaluating patient’s condition and pathogenesis of diabetes,therefor,which is worth researching further.更多还原