吡格列酮对老年冠心病合并糖尿病患者内皮祖细胞数量及脂联素水平的影响

Effect of pioglitazone on adiponectin and endothelial progenitor cells in elderly patients with coronary artery disease and diabetes mellitus

目的:观察吡格列酮对老年冠心病合并糖尿病患者外周血中内皮祖细胞(EPCs)数量及血脂联素水平的影响。方法:本研究共入选65例老年(年龄≥60岁)冠心病合并糖尿病患者,随机分为吡格列酮组和安慰剂对照组,用药12周后利用流式细胞术双色分析法检测2组患者外周血中EPCs的百分比,其中EPCs以CD34+/KDR+双标记阳性确定,对比2组患者在服药前后EPCs数量及血脂联素水平的变化。结果:2组患者用药前EPCs数量基本相近,观察12周后吡格列酮组患者EPCs数量显著增加(0.027±0.017vs0.046±0.03,P<0.05),对照组患者12周后EPCs数量虽较前有所增加,但无统计学差异。12周后2组患者脂联素水平均有所增加,但吡格列酮组患者治疗前后血脂联素水平显著升高(4.5±1.7mg/Lvs7.0±2.3mg/L,P<0.05)。结论:吡格列酮能够促进老年冠心病合并糖尿病患者EPCs的动员过程,还可提升患者血脂联素水平,可能具有抗动脉硬化功效。

Objective：To evaluate whether pioglitazone have the effect on endothelial progenitor cell（EPCs）mobilizing and the plasma level of adiponectin in elderly patients with coronary artery disease and diabetes mellitus.Methods：Sixty-five elderly patients with coronary artery disease and diabetes mellitus after successful percutaneous coronary intervention were randomized into pioglitazone group（n=32）or placebo group（n=33）.Peripheral blood samples were drawn at baseline and 12 weeks later to assess the number of EPCs and measure the plasma level of adiponectin.Circulating EPCs were defined by the surface markers CD34＋/KDR＋ and analyzed by flow cytometry.Results：CD34＋/KDR＋ cells were similar at baseline between the two groups.The number of EPCs were no significant change in the placebo group.In contrast,a significant increase of the number of EPCs was seen in the pioglitazone group（0.027±0.017vs0.046±0.03,P0.05）.The plasma levels of adiponectin,similar in the 2 groups at baseline,were significantly more increased by pioglitazone than by placebo at 12-week follow up（P0.05）.Conclusion：Pioglitazone have the effect on EPCs mobilizing and a potent anti-atherosclerosis function in elderly patients with coronary artery disease and diabetes mellitus.