S1P和CD69在2型糖尿病合并冠心病发病机制中的意义

发布时间：2018-08-12 10:38

【摘要】：目的：探讨2型糖尿病患者合并冠状动脉粥样硬化性心脏病发病机制的可能影响因素,尤其是生物活性脂质1-磷酸鞘氨醇(Sphingosine-1-phosphate, SIP)口T淋巴细胞CD69抗原的表达与2型糖尿病患者冠心病合并症的发生风险关系。方法：本研究自2013年10月至2014年6月间连续纳入2型糖尿病合并冠心病患者共68例(T2DM-CHD);同期纳入与之相匹配的2型糖尿病非冠心病患者共81例(T2DM)。利用酶联免疫吸附试验(ELISA)检测S1P的表达,流式细胞术,免疫荧光染色法检测植物血凝素(PHA)刺激20小时后外周血CD3+CD4+T淋巴细胞亚群CD69抗原的表达,同时收集包括高敏C反应蛋白(hsCRP)、各项血糖、血脂指标和体重在内的生化检测及临床信息。结果：T2DM组外周血S1P的浓度、HDL及ApoA1水平明显高于T2DM-CHD组(P0.01),而经PHA刺激后,CD3+CD4+T淋巴细胞亚群CD69抗原的表达明显低于T2DM-CHD组(尸0.01)。在单纯T2DM组中,包括hsCRP、FPG、2hPG、HbAlc、TC、TG、LDL、 ApoB、LP(a)在内的炎性标志物、脂质血糖指标及冠心病相关预防治疗用药史均较T2DM-CHD组明显降低,差异有统计学意义(P0.05)。同时,逻辑回归分析显示S1P是2型糖尿病患者独立保护因素,而T细胞CD69抗原、hsCP、2hPG、LDL、Lp (a)均为2型糖尿病患者合并冠心病的独立危险因素。结论：在2型糖尿病患者中,下降的外周血S1P表达水平及上调的CD3+CD4+CD69+ T细胞抗原、HsCRP等免疫炎性相关指标是2型糖尿病患者高冠心病合并风险的强力推动,与其发生发展具有密切相关性,可能参与了其病因途径。
[Abstract]:Objective: to investigate the possible influencing factors of coronary atherosclerotic heart disease in patients with type 2 diabetes mellitus. In particular, the expression of CD69 antigen in T lymphocytes of the mouth of bioactive lipids 1-phosphate (SIP) was associated with the risk of coronary heart disease in patients with type 2 diabetes. Methods: from October 2013 to June 2014, 68 patients with type 2 diabetes mellitus complicated with coronary heart disease (T2DM-CHD) and 81 matched non-coronary heart disease patients with type 2 diabetes mellitus (T2DM) were enrolled in this study. The expression of S1P was detected by enzyme-linked immunosorbent assay (ELISA), and the expression of CD69 antigen of CD3 CD4 T lymphocyte subsets in peripheral blood was detected by flow cytometry and immunofluorescence staining after 20 hours of stimulation with phytohemagglutinin (PHA). Biochemical and clinical information including blood glucose, blood lipids and body weight of Gao Min C reactive protein (hsCRP),) were also collected. Results the levels of S1P and ApoA1 in the peripheral blood of the group of w T2DM were significantly higher than those in the group of T2DM-CHD (P0.01), but the expression of CD69 antigen in T lymphocyte subsets of CD3 CD4 was significantly lower than that in the group of T2DM-CHD (P0.01). In the simple T2DM group, the inflammatory markers, lipid glucose index and the history of preventive therapy for coronary heart disease were significantly lower than those in the T2DM-CHD group (P0.05). At the same time, logistic regression analysis showed that S1P was an independent protective factor for type 2 diabetes mellitus, and T cell CD69 antigen hsCP2hPGL (a) was an independent risk factor for type 2 diabetic patients with coronary heart disease. Conclusion: in patients with type 2 diabetes, the decreased expression of S1P in peripheral blood and the up-regulation of CD3 CD4 CD69 T cell antigen (CD3 CD4 CD69 T cell antigen) and HsCRP are the strong driving factors of high risk of coronary heart disease in patients with type 2 diabetes. It is closely related to its occurrence and development and may be involved in its etiological pathway.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1;R541.4

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