大蒜素胶囊对冠心病合并糖尿病患者PCI术后预后及内皮功能的影响  

Effects of allitridi capsules on endothelial function and clinical prognosis after percutaneous coronary intervention in coronary artery disease patients with diabetes mellitus

作　　者：聂晓敏[1] 赵迎新[1] 史冬梅[1] 刘宇杨[1] 周志明[1] 苏利霄[1] 周玉杰[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科十二病房,100029

出　　处：《中华医学杂志》2013年第26期2052-2055,共4页National Medical Journal of China

摘　　要：目的观察大蒜素胶囊对冠心病合并糖尿病患者经皮冠状动脉介入治疗（PCI）术后预后及内皮功能的影响。方法连续入选拟行PCI术的冠心病合并糖尿病住院患者，数字表法随机分为对照组（n=60例）和大蒜素组（n=60例）。对照组给予常规治疗，药物组在常规治疗基础上加用大蒜素胶囊口服，每次40mg（2粒），3次／d，共3个月。分别于PCI术后即刻和3个月抽取外周静脉血，检测患者血清一氧化氮（NO）和细胞间黏附分子1（ICAM-1）水平；采用高分辨率彩色多普勒超声仪测定患者肱动脉内皮依赖性血流介导的血管舒张功能（FMD）。所有患者PCI术后随访1年。结果对照组和大蒜素组患者的临床基线资料差异无统计学意义（P〉0．05），基础FMD水平和血清NO、ICAM-1水平差异无统计学意义（P〉0．05）。PCI术后3个月，两组患者的临床资料情况差异无统计学意义，与对照组相比，大蒜素组患者FMD显著改善[（8．2±2．4）％比（6．4±2．3）％，P=0．013），血清NO水平升高[（147±32）μmol／L比（112±24）μmol／L，P=0．009]，ICAM-1水平下降[（182±21）μmol／L比（232±29）μmol／L，P=0．021]。PCI术后1年，大蒜素组主要不良心血管事件发生率为10．5％，显著低于对照组（17．2％，P=0．022）。结论冠心病合并糖尿病患者PCI术后口服大蒜素胶囊可改善临床预后，其机制可能与大蒜素改善血管内皮功能和血管炎症状态相关。Objective To explore the effects of allitridi capsules on endothelial function and clinical prognosis after percutaneous coronary intervention （PCI） in coronary artery disease （CAD） patients with diabetes mellitus（DM）. Methods A total of 120 CAD patients with DM undergoing PCI were randomly assigned to receive conventional（ control, n = 60） and additional allitridi treatment（ 120 mg/day, n = 60） for 3 months. Serum nitric oxide（NO） and intercellular adhesion molecule 1 （ICAM-1） levels were determined by enzyme-linked immunosorbent assay（ELISA） immediately and at 3 months post-PCI. Endothelial function was assessed by endothelium dependent flow-mediated dilation（FMD）. Duration of follow-up was 1 year after PCI. Results The clinical characteristics, serum NO and ICAM-1 levels and FMD at baseline were not different between two groups. At Month 3 post-PCI, serum NO level was markedly higher （ （ 147 ± 32） vs （ 112 ±24） μmol/L, P =0. 009） and serum ICAM-1 level was significantly lower （ （ 182 ± 21 ） vs （232 ± 29 ） μmol/L, P = 0. 021 ）in the allitridi group than in the control group. Furthermore, treatment of allitridi resulted in a significant improvement of FMD （ 8.2% ± 2.4% vs 6.4% ± 2. 3%, P = 0. 013 ）. At Year 1 post-PCI, the incidence of major adverse cardiovascular event（MACE） was lower in the allitridi group than that in the control group （ 10.5% vs 17.2%, P =0. 022 ）. Conclusions AUitridi capsules significantly improve the clinical prognosis after PCI in CAD patients with DM. Its mechanism may lies in improved endothelial function and vascular inflammatory state.

关 键 词：冠状动脉疾病 糖尿病 PCI术 内皮 血管 大蒜素 

分 类 号：R259[医药卫生—中西医结合]