| Objective: To measure the levels of serum vascular endothelial cadherin(VE-cadherin)and intercellular adhesion molecule-1(sICAM-1)in type 2 diabetic patients with lower-extremity arterial disease(LEAD)and their changes before and after arterial angiography.In addition,to explored the effect of interventional therapy on endothelial function and the correlativity between the change of endothelial fuction and vascular restenosis after intervention.Methods: Choose 23 type 2 diabetic patients with LEAD who underwent arterial angiography balloon dilation or stent implantation successfully in endocrinology department of our hospital from December 2015 to December 2016 as group A,at the same time,choose another 23 type 2 diabetic patients who were hospitalized in endocrinology department of our hospital as group B,in addition,choose 23 healthy individuals as group C.4 millilitre blood from cubital vein of all cases were taken after 10-hour of fasting at 6:00am to test the levels of fasting blood glucose(FBG),glycosylated hemoglobin(Hb A1c),cholesterol(TC),triglyceride(TG),highdensity lipoprotein(HDL-C),low-density lipoprotein(LDL-C),VE-cadherin and sICAM-1.During percutaneous lower extremity arteries intervention of group A,4ml of the arterial blood specimens were collected respectively from the arterial sheath after the successful placement of the arterial sheath(preinterventional arterial blood),or from distal artery of stenosis or occlusion site respectively after the guide wire and catheter passing through the arterial segment of stenosis or occlusion(ischmic area prior-interventional arterialblood)and after balloon dilatation or stent implantation(ischemicarea post-interventional arterial blood).Their levels of VE-cadherin and sICAM-1were tested.Patients of A group were supine to draw 4ml blood from cubital vein 24 hours and 14 days after the intervention(24h after intervention,14 d after intervention).The Blood samples collected were centrifuged at1000r/min,20 minutes conditions after standing at room temperature 2hours,the centrifugal radius was 15 cm.The supernatant was save-20 place in the ?refrigerator freeze.All the samples were subjected to the same manufacturers test kit.SPSS13.0 software was used for statistical analysis.The count data was using chi square test.The measurement data was shown bymeans±standard deviation.The comparision between multiple groups was performed by One Way analysis of variance(One-way ANOVA).T-test was used for the comparision between the two groups.Linear correlation analysis wased for the comparision among parameters.P<0.05 was considered statistically significant.Results:1 The comparison of the general data in the three groups: The age,sex and BMI in A,B,C three groups had no statistical significance(P>0.05).2 The levels of FBG and Hb A1 c among the three groups:In group A were respectively(8.30±1.13)mmol/L(8.40±1.34)%;in group B were respectively(8.10±1.15)mmol/L,(8.18±1.08)%;in group C were respectively(5.06±0.54)mmol/L,(4.92±0.35)%.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,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 levels of blood lipid among three groups:The levels of TC,TG,LDL and HDL:In group A were respectively(4.68±0.57)mmol/L,(1.81±0.78)mmol/L,(3.08±0.59)mmol/L,(1.19±0.30)mmol/L;in group B were respectively(4.79±1.00)mmol/L,(1.85±0.90)mmol/L,(2.78±0.38)mmol/L,(1.20±0.20)mmol/L;in group C were respectively(4.21±1.18)mmol/L,(1.38±0.70)mmol/L,(2.58±0.78)mmol/L,(1.25±0.41)mmol/L.The levels of TC,TG,LDL,HDLin group A,B and C had no statistical significance(P>0.05).4 The serum levels of VE-cadherin: The VE-cadherin levels of venous blood: in group A,B and C were:(11.06±0.75)ng/ml,(10.23±0.82)ng/ml,(9.53±0.77)ng/ml,the level in group A was higher than that in group B and group C(P<0.05;P<0.01),and the level in group B was higher than that in group C(P<0.05).The levels of 24-hour and 14-day post-interventional venous blood were(17.52±3.19)ng/ml and(12.80±0.84)ng/ml,which were significantly higher than the level of pre-interventional venous blood(P<0.01;P<0.05),and the level of 14-day post-interventional venous blood was lower than that of 24-hour(P<0.01).The VE-cadherin levels in arterial blood of group A: pre-interventional arterial blood were(11.08±0.97)ng/ml and there were no significant difference comparing with that in venous blood(P>0.05);ischemic area prior-interventional arterial blood were(12.33±1.12)ng/ml,which were higher than that of pre-interventional arterial blood(P<0.05);ischemic area post-interventional arterial blood were(15.08±1.63)ng/ml,which were significantly higher than that of pre-interventional arterial blood and ischemic area prior-interventional arterial blood(P<0.01,P<0.05).5 The serum levels of sICAM-1: The sICAM-1 levels of venous blood: in group A,B and C were:(2.92±0.22)ng/ml,(1.93±0.36)ng/ml,(0.61±0.15)ng/ml,the level in group A was higher than that in group B and group C(P<0.01,P<0.01),and the level in group B was higher than that in group C(P<0.01).The levels of 24-hourand 14-day post-interventional venous blood were(4.98±0.18)ng/m L and(6.06±0.34)ng/m L,which were significantly higher than the level of pre-interventional venous blood(P<0.01;P<0.01),and the level of 14-day post-interventional venous blood was higher than that of 24-hour(P<0.01).The sICAM-1 levels in arterial blood of group A: pre-interventional arterial blood were(2.93±0.22)ng/m L and there were no significant difference comparing with that in venous blood(P>0.05);ischemic area prior-interventional arterial blood were(3.55±0.37)ng/m L,which were higher than that of pre-interventional arterialblood(P<0.01);ischemic area post-interventional arterial blood were(4.29±0.26)ng/m L,which were significantly higher than that of pre-interventional arterial blood and ischemic area prior-interventional arterial blood(P<0.01,P<0.01).6 The correlation between VE-cadherin and sICAM-1: Liner correlation analysis was used to explore the correlation between VE-cadherin and sICAM-1 in venous blood of group B and pre-intervention of group A.Positive correlation existed between the levels of VE-cadherin and ICAM-1(r=0.629,P<0.01).7 The levels of ABI and Tc PO2:he levels of ABI and Tc PO2 in group B were 1.00±0.17,(45.58±8.30)mm Hg,which were significantly higher than the levels in group A,which were 0.47±0.12,(26.08±4.81)mm Hg(P<0.01;P<0.01).The levels of ABI and Tc PO2 in group A one day after intervention were 0.72±0.07,(43.67±4.96)mm Hg,which were significantly higher than the levels before intervention(P<0.01,P<0.01).Conclusions:1 The levels of VE-cadherin and sICAM-1 in serum were significantly higher in type 2 diabetic patients with LEAD,Conclusion VE-cadherin and sICAM-1 may play a key role in the development of LEAD and high level of VE-cadherin and sICAM-1 was one of the risk factors for LEAD.2 The levels of VE-cadherin and sICAM-1 were significantly higher after intervention,and the levels of 14-day after intervention had not returned to the preoperative levels,Which showed that the interventional treatment can further aggravate the impairment of vascular endothelial function,enhance inflammatory reaction,Provide the basis of protect endothelial integrity and Anti-inflammatory therapyfor postoperative. |
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