丹参注射液对糖尿病患者内皮NO、tPA储备和血管舒张功能的作用

Effects of Danshen Injection on the Reserve of Tissue Plasminogen Activator and Nitric Oxide in Endothelium and Vasodilatation in Diabetic Patients

目的观察丹参注射液对糖尿病患者内皮tPA、NO储备和血管舒张功能的作用。方法对32例Ⅱ型糖尿病患者和16例正常人,采用高频超声方法测定血管内皮依赖性和非依赖性舒张功能和颈总动脉内膜厚度,采用静脉闭塞试验测定tPA和NO储备释放。结果糖尿病组内皮依赖性舒张功能降低,NO、tPA释放减少,且有高血压组比无高血压组降低更甚,与正常组相比,P<0.01或0.05,而三组非依赖性血管舒张功能差异无显著性。糖尿病组颈总动脉内膜厚度增加,无高血压组与正常人相比差异无显著性,但有高血压组与正常人相比,P<0.05。在应用丹参注射液治疗后,糖尿病组患者内皮依赖性舒张功能增强,NO、tPA释放水平升高,与治疗前相比,P<0.01或0.05,有显著性差异。结论丹参注射液能有效地改善血管内皮细胞tPA、NO储备释放功能和内皮依赖性舒张功能,改善糖尿病微血管病变。

Objective:To investigate the effecs of Danshen Injection on the reserve of tissue plasminogen activator and nitric oxide in endothelium and vasodilatation in diabetic patients.Methods:32 patients and 16 normal individuals were enrolled into this study.The capacity of vascular endothelium to release tPA and NO was examined by venous occlusion of the upper arm.Brachial artery diameter was measured at baseline,during post occlusion reactive hyperemia (flow-mediated endothelium-dependent),and after sublingual nitroglycerol administration(endothelium-independent).Vasodilation was expressed as the percentage changes relative to the baseline diameter,while endothelial tPA and NO release was expressed as the percentage change relative to the baseline tPA and NO levels.Thickness of the intima of carotid artery was measured using ultrasound imaging.Results:There was no significant difference in eudothelum-independent vasodilation between the controls and diabetes.However,significant reduction in endothelium-dependent vasodilation,endothelial NO release and tPA release (P<0.05,or P<0.01) were found in diabetes compared with the controls and the reduction was lower in diabetes with hypertension than that in diabetes without it.At the same time,there was no difference in intimamedial thickness of the carotid artery between two groups,although the carotid artery in the diabetes without hypertension was much thicker than that in the control.But that in the diabetes with hypertension had significant difference compared with that in the control.Conclusion:Danshen Injection may improve the above-mentioned marks.And it may increase the endothelium-dependent vasodilation and endothelial tPA and NO release and improve the vascular disease in patients with diabetes mellitus.