前列地尔对早期糖尿病视网膜病变患者血管内皮功能的影响  

Effect of alprostadil injection on vascular endothelial function in early diabetic retinopathy patients

作　　者：卢伟波[1] 李舒敏[1] 吕以培[1] 黄中莹[1] 杨丕坚[1] 

机构地区：[1]钦州市第二人民医院,广西钦州535000

出　　处：《山东医药》2013年第24期50-52,共3页Shandong Medical Journal

摘　　要：目的观察前列地尔对早期糖尿病视网膜病变(DR)患者血管内皮功能变化的影响,并探讨其可能的机制。方法选择早期DR患者63例(观察组),分为A组31例和B组32例,两组均常规予人胰岛素治疗,A组静脉注射前列地尔10μg,1次/d,共用3周;另选体检健康者31例作为对照组。检测对照组及观察组治疗前后的空腹血糖(FBG)、糖化血红蛋白(HbA1C)、甘油三脂(TG)、总胆固醇(TC)、细胞间黏附分子1(ICAM-1)、超敏C反应蛋白(hs-CRP)及血内皮素1(ET-1),超声检测肱动脉血流介导的内皮依赖性血管舒张功能(FMD)。结果观察组治疗前FBG、HbA1C、TG、TC、ICAM-1、hs-CRP及ET-1均高于对照组(P均<0.05),FMD较对照组降低(P<0.05);A组治疗后外周血ET-1为(96.69±10.68)pg/mL、ICAM-1为(403.83±87.48)ng/mL、hs-CRP为(8.77±1.27)mg/L、FMD为11.89%±3.58%,B组分别为(184.6±10.79)pg/mL、(597.78±60.75)ng/mL、(18.79±2.43)mg/L、9.18%±0.55%;两组比较,P均<0.05。结论前列地尔能有效改善早期DR患者的血管内皮功能,该作用与其降低血ICAM-1、hs-CRP、ET-1水平有关。Objective To observe the effect of alprostadil injection on the changes of vascular endothelial function in early diabetic retinopathy patients and to investigate the possible mechanism. Methods Sixty-three cases of patients with early diabetic retinopathy （observation group） were divided into group A （31 cases） and group B （32 cases）. Two groups were treated with human insulin and group A was treated with alprostadil injection （ 10 ug iv q. d. ） for 3 weeks. Another 31 healthy subjects were selected as controls （the control group）. The levels of fasting blood glucose （FBG）, glycosylated hemoglobin （ HbAlc ）, triglyceride （ TG）, cholesterol （ TC）, intercellular adhesion molecule-1 （ ICAM-1 ）, high sensitivity C-reactive protein （hs-CRP）, and endothelin-1 （ET-1） were measured respectively before and after treatment in the control group and observation group, meanwhile the endothelium-dependent flow-mediated dilatation （FMD） of brachial artery was determined with ultrasound before and after treatment in the control group and observation group. Results The levels of FBG, HbAlc, TG ,TC, ICAM-1 ,hs-CRP and ET-1 in the observation group was higher than those of the control group before treatment （ all P 〈 0.05 ）, the FMD was lower than the control group （ P 〈 0.05 ）. After treatment the ET-1, ICAM- 1, hs-CRP, FMD in group A were （96.69 ± 10.68） pg/mL, （403.83 ± 87.48） ng/mL, （ 8.77 ± 1.27） mg/L and （11.89 ±3.58）%, those in group B were （184.6 ±10.79） pg/mL, （597.78 ±60.75） ng/mL, （18.79 ±2.43） mg/L and （9.18 ± 0.55 ） % ; there was statistical difference between group A and B （ all P 〈 0.05 ）. Conclusion The alprostadil can effectively improve the vascular endothelial function in patients with early diabetic retinopathy and its effect might associate with lowering the levels of ICAM-1, hs-CRP and ET-1.

关 键 词：糖尿病视网膜病变 内皮功能 前列地尔 细胞间黏附分子 超敏C反应蛋白 内皮素 

分 类 号：R587.1[医药卫生—内分泌]