Мобилизация эндотелиальных прогениторных клеток после проведения эндоваскулярных вмешательств у больных сахарным диабетом 2 типа

Цель.
Изучить мобилизацию эндотелиальных прогениторных клеток (ЭПК) у больных сахарным диабетом 2 типа (СД2) после эндоваскулярных вмешательств на коронарных и периферических артериях.
Материалы и методы.
Количество ЭПК определяли методом проточной цитофлюориметрии у 42 пациентов до и на 2?4-й день после проведения эндоваскулярного вмешательства. ЭПК идентифицировались как CD34+VEGFR2+CD45- и CD34+CD133+CD45-клетки. Пациенты были разделены на 2 группы: 23 человека вошли в группу СД2 и 19 ? в группу лиц без нарушения углеводного обмена.
Результаты.
Количество ЭПК в периферической крови у больных СД2 до и после эндоваскулярного лечения достоверно не отличалось. В группе больных без СД2 уровень CD34+VEGFR2+CD45-клеток после операции увеличился на 55,5% (p <0,01), CD34+CD133+CD45-клеток ? на 27,7% (p <0,05). В подгруппе пациентов с СД2 и уровнем HbA_1c ?7,5% после эндоваскулярного вмешательства наблюдалось повышение CD34+VEGFR2+CD45-клеток на 46,6% (p=0,01), а CD34+CD133+CD45-клеток ? на 40,3% (p=0,006) по сравнению с подгруппой пациентов с СД2 и уровнем HbA_1c >=7,5%.
Заключение.
У больных СД2 наблюдалось нарушение мобилизации ЭПК после проведения эндоваскулярных вмешательств. Кроме того, динамика ЭПК зависела от степени компенсации углеводного обмена. Так, в подгруппе больных СД2 с уровнем HbA_1c ?7,5% отмечалось достоверное повышение ЭПК после эндоваскулярных вмешательств.

сахарный диабет, эндотелиальные прогениторные клетки, мобилизация, чрескожные коронарные вмешательства, реваскуляризация нижних конечностей

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