【摘要】 目的　探讨 2型糖尿病 (DM)患者血循环内皮细胞 (CEC)数的变化以了解其在血管病变发病中意义。方法　检测 5 5例DM患者及 18例正常人CEC数和血清肿瘤坏死因子α(TNFα)水平并进行比较。结果　DM患者外周血CEC数明显高于正常人 (P <0 .0 0 1) ,视网膜病变组 (P <0 .0 1)和高血压组 (P <0 .0 1)CEC数增高更明显 ,临床糖尿病肾病组CEC数明显高于早期糖尿病肾病组 (P <0 .0 1)及尿白蛋白正常组 (P <0 .0 1)。患者CEC数与病程、TNFα水平、尿白蛋白排泄率、收缩压及舒张压呈显著正相关 (r =0 .34、0 .72、0 .6 9、0 .6 5和 0 .5 7,P均 <0 .0 5 )。结论　血管内皮细胞损伤是糖尿病血管病变发生的主要因素之一 ,CEC数检测对 2型糖尿病肾病的病情分析有重要的临床价值。更多还原

【Abstract】 Objective To explore the significance of the injury of vascular endothelial cells (VEC) in the pathogenesis of diabetic angiopathy by measuring the number of circulating endothelial cells (CEC) in patients with type 2 diabetes mellitus (DM). Methods The number of CEC and the serum level of tumor necrosis factor alpha (TNFα) were measured in 18 normal controls (NC group) and 55 cases of type 2 DM, including 20 cases without albuminuria (SDM group), 20 cases with trace albuminuria (EDN group) and 15 cases with clinical albuminuria (CDN group). Results The number of CEC was markedly elevated in DM, SDM, EDN and CDN groups than that in NC group (P<0.001, 0.05, 0.01 and 0.01, respectively). The number of CEC in CDN group was significantlyhigherthanthatinSDM (P<0.01) and EDN group (P<0.01). The CEC number was significantly elevated in patients with diabetic retinopathy (DR) compared with those without DR (P<0.005). The CEC number was significantly higher in diabetic patients with hypertension compared with those without hypertension (P<0.001). There was significant positive correlation between CEC number and diabetes duration, serum TNFα level, urine albumin excretion rate, systolic pressure, diastolic pressure (r=0.34, 0.72, 0.69, 0.65 and 0.57, respectively, P<0.05) for all of them. Conclusion VEC injury may play an important role in the pathogenesis of diabetic angiopathy and CEC count can be used as a reference for evaluating the severity of diabetic nephropathy in type 2 DM.更多还原