短期强化辛伐他汀治疗对老年2型糖尿病患者体内核因子κB活性及血浆炎症相关因素影响

Study of Simvastatin Short-term Intensive Treatment on Activity of NF-κB and Inflammation-Related Factors in Type 2 Diabetes with or without Macro-Vascular Complications

目的观察血脂正常的老年2型糖尿病患者经辛伐他汀短期强化治疗前后体内核因子κB活性及血浆炎症相关因素的变化,评估其对老年2型糖尿病及其大血管并发症患者的保护作用。方法 64例老年2型糖尿病患者,男女各32例,口服辛伐他汀40mg/d治疗2周,治疗前后分别检测核因子κB活性及血浆炎症因子水平、CRP、外周血单个核细胞计数。结果①大血管病变组年龄、糖尿病病程、空腹血糖、血肌酐、24 h尿微量白蛋白、收缩压、核因子κB活性、血浆炎症相关指标CRP、外周血单个核细胞计数、炎症因子IL-6、TNF-α明显高于无大血管病变组,血浆炎症抑制因子IL-10水平明显低于无大血管病变组;②老年2型糖尿病及其大血管并发症患者经辛伐他汀短期强化治疗后血浆炎症因子IL-6、TNF-α、CRP、外周血单个核细胞计数明显降低;血浆炎症抑制因子IL-10水平明显升高。结论老年2型糖尿病患者血浆CRP水平、外周血单个核细胞计数明显增高,处于炎症状态。辛伐他汀短期强化治疗能显著减低2型糖尿病患者血浆CRP、外周血单个核细胞计数、核因子κB活性、炎症因子IL-6、TNF-α水平,上调血浆炎症抑制因子IL-10水平。这为老年2型糖尿病患者使用辛伐他汀预防心脑血管疾病提供临床证据。

Objective To observe the change of plasma inflammatory cytokines level in normal lipid type 2 diabetic patients before and after the treatment of Simvastatin short-term intervention and evaluate the protection effect on Type 2 diabetic patients with macro-vascular complications.Methods Totally 32 type 2 diabetic patients were divided into two groups： male patients（32 cases）,female patients（32 cases）.They were given 40mg/d simvastatins for two weeks.Plasma activity of NF-Κb,IL-6,TNF-α and IL-10 level,CRP,peripheral blood mononuclear cells in each group before and after treatment were detected.Results ①The during,fasting blood glucose,creatinine,24h-urine micro-albumin,Systolic pressure significantly higher than the group without macro-vascular complications.②The plasma IL-10 level in two type 2 diabetes groups were significantly increased after the short-term simvastatins treatment;the plasma IL-6 and TNF-α,CRP level and the number of peripheral blood mononuclear cells of patients were significantly decreased.Conclusion For Type 2 diabetic patients,the CRP level and the number of peripheral blood mononuclear cells were markedly increased,which means the patients are in the inflammatory state.The short-term simvastatins treatment can obviously decrease the activity of NF-Κb,the plasma IL-6,TNF-α,CRP level and peripheral blood mononuclear cell number and increase the plasma IL-10 level of Type 2 diabetic patients,which offers the clinical evidences for Type 2 diabetic patients to use simvastatins for preventing cerebral-vascular diseases.