丹参酮胶囊联合贝前列素钠片治疗老年糖尿病合并颈动脉粥样硬化疗效及对血清炎性因子及内皮细胞功能的影响

Effect of tanshinone capsule combined with beraprost sodium tablets on elderly diabetes mellitus with carotid atherosclerosis and its effect on serum inflammatory factors and endothelial function

目的观察丹参酮胶囊联合贝前列素钠片治疗老年糖尿病合并颈动脉粥样硬化(CAS)患者的疗效及对血清炎性因子和内皮细胞功能的影响。方法将150例老年糖尿病合并CAS患者随机分为观察组75例和对照组75例,2组均给予基础糖尿病治疗,对照组在此基础上给予贝前列素钠片口服,观察组在对照组基础上给予丹参酮胶囊口服,2组疗程均为3个月。观察2组治疗前后血脂血糖相关指标[空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、三酰甘油(TG)、胆固醇(TC)]、颈动脉内膜中层厚度(IMT)、斑块Crouse积分、斑块数量、斑块面积及炎性因子[血清单核细胞趋化蛋白-1(MCP-1)、超敏C反应蛋白(hsCRP)、肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附分子-1(sICAM-1)]和血管内皮细胞功能[血清一氧化氮(NO)、内皮素-1(ET-1)、肱动脉内皮依赖性舒张功能(FMD)、含服硝酸甘油后肱动脉内皮依赖性舒张功能(NID)]变化情况。结果 2组治疗后FPG、Hb A1c、TG、TC、MCP-1、sICAM-1、hs-CRP、TNF-α、ET-1水平及IMT、斑块Crouse积分、斑块数量、斑块面积均明显低于或少于治疗前(P均<0.05),NO、FMD、NID均明显高于治疗前(P均<0.05),且观察组上述指标改善情况均明显优于对照组(P均<0.05)。结论丹参酮胶囊联合贝前列素钠片能够显著调节老年糖尿病合并CAS患者的血糖血脂,减少斑块厚度及面积,并抑制粥样硬化进程,其机制可能与抑制血清炎性因子及改善血管内皮细胞功能有关。

Objective It is to observe the effect of tanshinone capsule combined with beraprost sodium tablets on elderly diabetes mellitus with carotid atherosclerosis and its effect on serum inflammatory factors and endothelial function. Methods150 cases of senile diabetic patients with carotid atherosclerosis were randomly divided into observation group and control group with 75 cases in each group. Both groups were given basic therapy for diabetes,additionally,the control group was treated with beraprost sodium tablets by oral administration,the observation group was treated with beraprost sodium tablets ＋ tanshinone capsule. Both groups were treated for 3 months. The changes of correlated indexes of blood fat and sugar [fasting plasma glucose（FPG）,glycosylated hemoglobin（HbA1c）,three acyl glycerin（TG）,cholesterol（TC） ],intima-media thickness（IMT） and plaque Crouse scores,plaque number,plaque area and inflammatory factors [serum monocyte chemotactic protein1（MCP-1）,hypersensitive c-reactive protein（hs-CRP）,tumor necrosis factor alpha（TNF-α）,soluble intercellular adhesion molecule 1（sICAM-1） ]and vascular endothelial function [serum nitric oxide（NO）,endothelin 1（ET-1）,brachial artery endothelium-dependent relaxing function（FMD）,brachial artery endothelium-dependent relaxing function after nitroglycerin（NID） ] before and after treatment in both groups were observed. Results After treatment the levels of FPG,HbA1 c,TG,TC,MCP-1,sICAM-1,hs-CRP,TNF-α,ET-1 and IMT,plaque Crouse scores,plaque number,plaque area were significantly lower or less,while the levels of NO,FMD and NID were higher than those before treatment in both groups（P〈0. 05）,and the improvements in observation group were obviously better than that of control group（P〈0. 05）. Conclusion Tanshinone capsule combined with beraprost sodium tablets can significantly improve blood sugar and fat,reduce plaque thickness and area,and inhibit the development of atherosclerosis in the senile diabetic patients with carotid atherosclerosis,its mechanism may be related to inhibition of serum inflammatory factors and improvement of endothelial function.