新型胰岛素增敏剂对急性心肌梗死患者炎症因子的抑制作用

Inhibition of New Insulin Sensitizers on Inflammatory Cytokines in the Patients with Acute Myocardial Infarction

目的 探讨新型胰岛素增敏剂（吡格列酮）对急性心肌梗死患者炎症因子热休克蛋白60 （HsP60）和C反应蛋白（CRP）水平的影响.方法 选择2型糖尿病伴急性心肌梗死患者38例,随机分为吡格列酮组（19例）和非吡格列酮组（19例）,吡格列酮组应用吡格列酮（艾汀）15mg/d及诺和灵30R皮下注射,非吡格列酮组只应用诺和灵30R皮下注射.两组均于入院时、入院14d、入院28d抽空腹静脉血测定血清HSP60、C-反应蛋白（CRP）.同时选择健康体检者20例作为对照组,于体检时抽空腹静脉血测定血清HSP60,CRP水平.结果 ①入院时吡格列酮组、非吡格列酮组与对照组比较,血清HSP60,CRP水平明显升高（P＜0.01）；吡格列酮组血清HSP60,CRP水平与非吡格列酮组比较无显著差异（P＞0.05）.②入院第14天吡格列酮组与非吡格列酮组比较,血清HSP60,CRP水平均明显降低（P＜0.05）；③入院第28天吡格列酮组与非吡格列酮组比较,血清HSP60、C反应蛋白水平均明显降低（P＜0.05）；④吡格列酮组入院28d与入院14d比较,血清HSP60,CRP水平明显降低（P＜0.05）.结论 吡格列酮通过抑制炎症因子血清HSP60和C反应蛋白分泌,对急性心肌梗死患者具有心血管保护作用.

Objective To investigate the effects of new insulin sensitizers（pioglitazone） on inflammatory cytokines（ heat shock prntein-60 and C-reactive protein） eoneentration in the patients of acute myocardial infarction（AMI）. Methods Thirty-eight cases of type-2 diabetics aeenmmpanied with AMI were randomly divided into pioglitazone group（ 19 cases） and non-pioglitazone group{ 19 cases）. The patients in pioglitazone group were given pioglitazone 15mg once a day. All patients were given insulin to control the blood glucose; Nineteen heahhy people who had physical examination were enrolled as eontrol group. The concentrations of HSP60 and CRP were measured in all patients on the day they came into the hospital and in 14th day and in 28th day. Results ①The concentration of HSP60 and CRP in pioglita- zone group and non-pioglitazone group was higher than those in eontrol group on the day they came into the hospital（P 〈 0.05）. ②The concentralion of HSP60 and CRP in pioglitazone group were lower than those in non-pioglitazone group when they stayed in the hospital for 14 days（ P 〈0.05） ;③The concentration of HSP60 and CRP in pioglitazone group was lower than those in non-pioglitazone group when they stayed in the hospital for 28 days（ P 〈 0.01 ）. ④The concentration of HSP60,CRP in pioglitazone group when they stayed in the hospital for 28 days were lower than those when they stayed in the hospital for 14 days（P 〈0. 01 ）. Conclusion New insulin sensitizers（ Pioglitazone） can protect the myocardial of the Patients with Acute Myocardial Infarction by inhibits the incretion of Inflammatory cytokines（ HSP60 and CRP）.