硫辛酸抗氧化应激对糖尿病心肌病患者8-羟基脱氧鸟苷酸水平和心功能的影响  

Clinical evaluation the efficacy of Alpha Lipoic Acid in treatment of the cardiac function and the 8-OHdG in diabetic cardiomyopathy patients.

作　　者：白伟伟[1] 赵林双[2] 向光大[2] 翟振艳[2] 周子华[3] 谭学莹[2] 

机构地区：[1]南方医科大学研究生院,广州510510 [2]广州军区武汉总医院内分泌科 [3]华中科技大学同济医学院附属协和医院心血管病研究所

出　　处：《临床内科杂志》2013年第4期237-240,共4页Journal of Clinical Internal Medicine

基　　金：湖北省重点攻关课题（2006AA3011361-2）

摘　　要：目的探讨α-硫辛酸抗氧化应激治疗对糖尿病心肌病患者8-羟基脱氧鸟苷酸（8-OHdG）和心功能的影响。方法随机选择71例糖尿病心肌病（DC）患者、73例单纯糖尿病（DM）患者和40例健康体检者，采用酶联免疫吸附法（ELISA）测定3组受试者血清8-OHdG水平。将71例糖尿病心肌病患者随机分为抗氧化治疗组（DC1组，37例）和非抗氧化治疗组（DC2组，34例），两组患者均在糖尿病饮食、常规胰岛素治疗的基础上给予阿司匹林100mg／d，地高辛0．125mg／d，硝酸异山梨酯10mg，1日3次，氢氯塞嗪12．5mg,／d口服；DC1组加用α-硫辛酸（ALA）600mg加入生理盐水250ml，静脉滴注，2周为1个疗程，6周后实施第2个疗程。DC2组不进行抗氧化治疗。DM组患者给予糖尿病饮食、常规胰岛素治疗。采用超声心动图及临床疗效总评定评价糖尿病心肌病患者的心功能。治疗结束后复查糖尿病心肌病患者血清8-OHdG水平。结果糖尿病心肌病患者8-OHdG水平[（320．7±18．4）ng／m1]明显高于DM组[（96．2±3．1）ng／ml]和对照组[（44．7±6．3）ng／ml，P〈0．05]；DC1组治疗后血清8-OHdG水平明显下降，与治疗前比较差异有统计学意义（P〈0．05）。两组心功能临床疗效总评定，DC1组治疗后有效率为86．0％，明显高于DC2组（50．O％），两组比较差异有统计学意义（P〈0．01）。结论糖尿病心肌病发病机制与氧化应激有关，抗氧化应激治疗糖尿病心肌病具有重要的临床价值。Objective To investigate the effects of Alpha Lipoic Acid in treatment of the cardiac function and the level of 8-OhdG in Diabetic cardiomyopathy. Methods The Diabetic cardiomyopathy pa- tients （n = 71 ）were divided into the control group （34 patients）and the treated group （37 patients）random- ly. Patients were given the following drugs respectively,Aspirin 100 mg po, qd, Isosorbide dinitrate 10 mg po,tid, Hydrochlorothiazide 12.5 mg po, qd, Digoxins 0. 125 mg po, qd. Alpha Lipoic Acid 600 mg daily was used drugs in the treatment group for 14 daily injection,not drugs in the contriol group by After a 24 week period therapy,with double-blind method echocardiography was used to compare some cardiac pa- rameter before and after treatment the 8-OhdG by ELISA. Results The findings showed higher elevated serum 8-OHdG in patients with diabetic myocardial disease. Diabetic cardiomyopathy group of the 8-OhdG was higher than those diabetes mellitus and healthy blood donors （ P 〈 0.05, P 〈 0.01 ）. The results showed that the indites of left vertricular systole （LVEDV, LVESV, EF） had been significantly improved in the treated gruop（P 〈 0.05 ,P 〈 0. 01 ）. The evaluation on clinical therapeutical effect showed that the total effective rate of the treated gruop was 86.0% ,which revealed significant differences with the to con- trois was 50.0% （P 〈 0.01 ）. Conclusion The findings suggest that these elevated serum 8-OHdG may play important roles in the pathogenesis of diabetic cardiomyopathy. Alpha Lipoic Acid is shown to be ef- fective and safe in the treatment of diabetic cardiomyopathy.

关 键 词：糖尿病心肌病 8-羟基脱氧鸟苷酸 Α-硫辛酸 心功能 

分 类 号：R587.2[医药卫生—内分泌]