降糖治疗对老年冠心病合并糖尿病患者外周血内皮祖细胞影响的研究

Effect of hypoglycemic agents on EPC marked with CD34 and VEGFR-2 in elderly patients with CHD accompanying diabetes mellitus

目的探讨降糖药物对老年冠心病合并糖尿病患者外周血CD34与血管内皮生长因子受体2(VEGFR-2)共同标记的血管内皮祖细胞(EPC)水平的影响。方法选择确诊的冠心病患者85例,根据口服葡萄糖耐量试验结果分为冠心病组41例,冠心病合并糖尿病组(合并组)44例,采用流式细胞仪检测2组外周血CD34及VEGFR 2双阳性的EPC(CD34^+/VEGFR-2^+EPC)水平;合并组患者降糖治疗,血糖稳定4周后门诊随访,观察外周血CD34^+/VEGFR-2^+EPC水平的变化。结果合并组外周血CD34^+/VEGFR-2^+EPC水平较冠心病组明显降低(P<0.05);合并组治疗后外周血CD34^+/VEGFR-2^+EPC水平较治疗前明显上升(P<0.05);EPC百分比与糖化血红蛋白水平呈负相关(r=-0.771,P<0.05)。结论降糖治疗可减轻高血糖水平对CD34^+/VEGFR-2^+的影响,使EPC耗损减少,有利于减缓冠状动脉粥样硬化进程。

Objective To study the effect of hypoglycemic agents on endothelial progenitor cells （EPC） marked with CD34 and VEGFR-2 in elderly patients with coronary heart disease（CHD） accompanying diabetes mellitus （DM）. Methods Eighty-five CHD patients accompanying DM were divided into CHD group（n=41）and CHD accompanying DM group（n=44）. Their CD34 and VEGFR-2 positive EPC（CD34＋/VEGFR-2＋ EPC）were detected by flow cytometry. Patients in CHD accompanying DM group were treated with hypoglycemic agents and followed up 4 weeks after their blood glucose became stable,during which the. CD34＋ and VEGFR-2＋ EPC were observed. Results The percentage of CD34＋ and VEGFR-2＋ EPC was significantly lower in CHD accompanying DM group than in CHD group（P〈0.05） and significantly higher in CHD accompanying DM group after treatment than before treatment with hypoglycaemic agents（P〈0.05）. The percentage of CD34＋ and VEGFR-2＋ EPC was negatively related with the HbAlc in CHD accompanying DM group（r=-0. 771,P〈0.05）. Conclusion Treatment of elderly CHD patients accompanying DM with hypoglycemic agents can alleviate the effect of high blood glucose level on CD34＋ and VEGFR-2＋ EPC,and is thus beneficial for delaying the progress of atherosclerosis.