【摘要】 目的 探讨IRS-1和内皮型一氧化氮合酶(eNOS)与糖尿病下肢血管病变及糖尿病足的发病关系，为临床预防及治疗糖尿病下肢血管病变提供试验依据。 方法 采用实时RT-PCR检测糖尿病足(DF)组、糖尿病下肢血管病变(DMPAD)组、糖尿病(DM)组及正常对照(NC)组外周血单个核细胞IRS-1及eNOSmRNA表达，并采集各组临床生化资料。计算HOMA-IR。采用方差分析，秩和检验及直线相关进行组间比较及各指标相关关系的分析。 结果 DM、DMPAD和DF组TG、TC、FPG、2 hPG、HbA1c、HOMA-IR均高于NC组(P<0.05)，DMPAD和DF组TG，LDL-C及病程高于DM，HDL-C低于DM(P<0.05)。IRS-1mRNA和eNOS mRNA表达NC组最高[1(0.70,1.41),1(0.65,1.53)]，DF组最低[0.26(0.10,0.62),0.18(0.11,0.31)](P<0.05)。DM、DMPAD、DF组IRS-1与eNOS mRNA表达呈直线相关，Correlation Matrix分别为0.4638，0.5471，0.5023(P<0.05)。 结论 IRS-1可能通过下调eNOS的表达参与了糖尿病下肢血管病变及糖尿病足的发生发展。

　　【关键词】 糖尿病下肢血管病变;糖尿病足);胰岛素受体底物-1;内皮型一氧化氮合酶;胰岛素抵抗

　　The effect of IRS-1 and eNOS on the development of diabetic lower extremity arterial disease and diabetic foot QIN Jiang-yuan,TIAN Luo-bing,LIU Guan-hua.Tangshan Gongren Hospital,Tangshan 063000,China

　　Correspongding author：Fang Hui，Email：fanghui@medmail.com

　　【Abstract】 Objective To study the relationship between the factors,IRS-1 and Endothelial nitric oxide synthase(eNOS), and the development of diabetic lower extremity arterial lesions and diabetic foot,so as to provide experimental evidence for clinical prevention and treatment of diabetic lower extremity arterial lesions. Method The expressions of IRS-1 and eNOS in peripheral blood mononuclear cells were tested in diabetic foot (DF),diabetic lower extrimity arterial lesions(DLEAL),diabetes(D) and normal control(NC) groups by Real-Time PCR.Clinical and biochemical data of each group were collected and their HOMA-IR were calculated.Variance analysis，Kruskal-Wallis Test and Linear Correlation Analysis were applied in the intergroup analysis and correlation analysis. Results TG，TC，FPG，2 hPG ，HbA1c and HOMA-IR were lower in NC group than in any other groups(P<0.05).TG ，LDL-C and clinical course was higher in DLEAL and DF groups than in D group，while HDL-C was lower(P<0.05). The expressions of IRS-1 and eNOS mRNA in NC group were [1(0.70,1.41),1(0.65,1.53)],both the highest among all the groups,while the DF group has the lowest data, that is [0.26(0.10,0.62),0.18(0.11,0.31)](P<0.05). The expression of IRS-1 had linear correlation to that of eNOS in D,DLEAL, and DF groups(Correlation Matrix=0.4638,0.5471,0.5023.P<0.05). Conclusion IRS-1may participate in the development of diabetic lower extremity arteriallesions and diabetic foot by suppressing eNOS expression.

　　【Key words】Diabetic lower extremity arterial disease(DMPAD);Diabetic foot(DF); Insulin receptor substrate-1(IRS-1);Endothelial nitric oxide synthase(eNOS);Insulin resistance(IR)