| Objective: By measured the levels of serum lipoprotein-associated phospholipase A2(Lp-PLA2) and macrophage migration inhibitory factor(MIF) in type 2 diabetic patients with lower-extremity arterial disease(LEAD) and their changes before and after arterial angiography, balloon dilation or stent implantation, to explore the clinical significance of Lp-PLA2 and MIF in the development of peripheral arterial disease in type 2 diabetic patients and effects of interventional therapy on them.Methods: Choose 28 type 2 diabetic patients with LEAD who underwent arterial angiography, balloon dilation or stent implantation successfully in endocrinology department of our hospital from December 2013 to December 2014 as group A, at the same time, choose another 28 type 2 diabetic patients who were hospitalized in endocrinology department of our hospital as group B, in addition, choose 28 healthy individuals as group C. The patients of group A and group B under supine position were drew 4ml of venous blood from cubital veins under fasting conditions the next day after adimission, to test the levels of fasting blood glucose(FBG), glycosylated hemoglobin(Hb A1c), cholesterol(TC), triglyceride(TG), low-density lipoprotein(LDL), high- density lipoprotein(HDL), Lp-PLA2 and MIF, and the patients of group C were drew venous blood under the same conditions to test the above- mentioned indexes. During the intervenional treatment of group A, after the successful placement of artery sheath, 4ml of arterial blood were drew from artery sheath(arterial blood before intervention), after the guide wire and catheter passing through the arterial segment of stenosis or occlusion, 4ml of arterial blood were drew from the distal part of pathological artery(arterial blood of ischemic area before intervention), and after balloon dilatation or stent implantation, 4ml of arterial blood were drew from the distal part of pathological artery(arterial blood of ischemic area after intervention), furthermore 4ml of venous blood of group A were drew respectively on the 1st day and 7th day after intervention to test the levels of Lp-PLA2 and MIF. In addition, the patients of group A were tested ABI and Tc PO2 respectively one day before and after intervention. SPSS 13.0 software was used for statistical processing, and the measurement date was shown by means±standard deviation. Statistical analysis between multiple groups were tested by one way analysis of variance. Enumeration data was tested by chi square test. Statistical analysis between two groups was tested by T-test. The correlation among parameters was tested by linear correlation analysis. P<0.05 was considered statistically significant.Results:1 The age, sex and BMI in A, B, C three groups had no statistical significance(P>0.05).2 The comparision of FBG and Hb A1 c among A, B, C three groups: The levels of FBG, Hb A1 c in group A were respectively(8.95±1.12)mmol/L,(8.87±1.14)%; the levels of FBG, Hb A1 c in group B were respectively(9.36±1.13)mmol/L,(9.26±1.08)%; the levels of FBG, Hb A1 c in group C were respectively(5.32±0.58)mmol/L,(5.27±0.57)%. Compared with group C respectively, the levels of FBG, Hb A1 c in group A and group B were significantly higher, the differences were statistically significant(P<0.01). The levels of FBG, Hb A1 c in group A and group B had no statistical significance(P>0.05).3 The comparision of the lipid variation among A, B, C three groups: The levels of TC, TG, LDL, HDL in group A were respectively(4.92±0.89)mmol/L,(1.80±0.61)mmol/L,(3.80±0.46)mmol/L,(1.13±0.16)mmol/L; the levels of TC, TG, LDL, HDL in group B were respectively(4.59±0.76)mmol/L,(1.61±0.52) mmol/L,(3.57±0.44)mmol/L,(1.16±0.21)mmol/L; the levels of TC, TG, LDL, HDL in group C were respectively(4.12±0.66)mmol/L,(1.52±0.43)mmol/L,(3.07±0.51)mmol/L,(1.23±0.23)mmol/L. The levels of TG, HDL in A, B, C three groups had no statistical significance(P>0.05). Compared with group C respectively, the levels of TC, LDL in group A and group B were significantly higher, the differences were statistically significant(P<0.01 or P<0.05). The levels of TC, LDL in group A and group B had no statistical significance(P>0.05).4 The comparision of Lp-PLA2, MIF among A, B, C three groups: The levels of Lp-PLA2 of venous blood in A, B, C three groups before intervention were respectively(67.79±7.02)ng/ml,(46.26±6.00)ng/ml,(42.76±7.28)ng/ml. Compared with group B and group C respectively, the level of Lp-PLA2 in group A was significantly higher, the differences were statistically significant(P<0.01). The levels of Lp-PLA2 in group B and group C had no statistical significance(P>0.05). The levels of MIF in A, B, C three groups before intervention were respectively(28.12±2.36)ng/ml,(21.98±2.50)ng/ml,(20.95±1.98)ng/ml. Compared with group B and group C respectively, the level of MIF in group A was significantly higher, the differences were statistically significant(P<0.01). The levels of MIF in group B and group C had no statistical significance(P>0.05).5 The comparision of ABI and Tc PO2 before and after intervention: The levels of ABI and Tc PO2 in group A one day before intervention were respectively 0.50±0.09,(37.11±2.57)mm Hg. The levels of ABI and Tc PO2 in group A one day after intervention were respectively 0.84±0.08,(62.72±3.82)mm Hg. The levels of ABI and Tc PO2 after intervention were significantly higher than before intervention(t=15.60, P<0.01; t=30.99, P<0.01).6 The comparision of Lp-PLA2, MIF of arterial blood in group A: The levels of Lp-PLA2 of arterial blood before intervention, arterial blood of ischemic area before and after intervention were respectively(67.42±6.37)ng/ml,(72.04±7.43)ng/ml,(100.90±9.11)ng/ml. Compared with arterial blood before intervention and arterial blood of ischemic area before intervention respectively, the level of Lp-PLA2 of arterial blood of ischemic area after intervention was significantly higher, the difference were statistically significant(P<0.01). Compared with arterial blood before intervention, the level of Lp-PLA2 of arterial blood of ischemic area before intervention was significantly higher, the difference was statistically significant(P<0.05). The levels of MIF of arterial blood before intervention, arterial blood of ischemic area before and after intervention were respectively(28.89±3.07)ng/ml,(32.87±3.83)ng/ml,(44.72±4.24)ng/ml. Compared with arterial blood before intervention and arterial blood of ischemic area before intervention respectively, the level of MIF of arterial blood of ischemic area after intervention was significantly higher, the difference were statistically significant(P<0.01). Compared with arterial blood before intervention, the level of MIF of arterial blood of ischemia area before intervention was significantly higher, the difference was statistically significant(P<0.01).7 The comparision of Lp-PLA2, MIF of venous blood in group A: The level of Lp-PLA2 of venous blood before intervention, one day after intervention and seven days after intervention were respectively(67.79±7.02)ng/ml,(90.81±7.77)ng/ml,(76.93±8.12)ng/ml. Compared with venous blood before intervention, the level of Lp-PLA2 of venous blood one day after intervention was significantly higher(P<0.01). The level of Lp-PLA2 of venous blood seven days after intervention was significantly lower than venous blood one day after intervention(P<0.01), but higher than venous blood before intervention significantly(P<0.01). The levels of MIF of venous blood before intervention, one day after intervention and seven days after intervention were respectively(28.12±2.36)ng/ml,(41.35±3.48)ng/ml,(39.42±3.69)ng/ml. Compared with venous blood before intervention, the level of MIF of venous blood one day after intervention was significantly higher(P<0.01). The level of MIF of venous blood seven days after intervention was significantly lower than venous blood one day after intervention(P<0.05), but higher than venous blood before intervention significantly(P<0.01).8 The correlation between Lp-PLA2 and MIF: Liner correlation analysis was used to measure the correlation between Lp-PLA2 and MIF in venous blood of group A before intervention. Positive correlation existed between the levels of Lp-PLA2 and MIF(r=0.887, P<0.01).Conclusions:1 The levels of Lp-PLA2 and MIF in serum were significantly higher in type 2 diabetic patients with LEAD, which showed that Lp-PLA2 and MIF might be related with the occurrence and development of LEAD in type 2 diabetic patients.2 The levels of Lp-PLA2 and MIF in type 2 diabetic patients with LEAD were significantly higher after intervention, meaning inflammatory reaction enhanced, which may increase the risk of arterial restenosis and thrombosis after interventional therapy. Therefore, anti-inflammation treatment is necess- ary for patients after interventional therapy. |
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