丹参多酚酸盐联合甲钴胺对2型糖尿病伴心肌病患者血清中ACE2和Ang-(1-7)含量的影响  

Effect of salvianolate combined with mecobalamin on levels of serum ACE2 and Ang-( 1-7)in patients with type 2 diabetes mellitus and cardiomyopathy

作　　者：冯诗婷[1] 李丽[1] 林云[1] 史丽[2] 

机构地区：[1]海南医学院第一附属医院,海口570102 [2]海南医学院第二附属医院,海口570311

出　　处：《中药药理与临床》2017年第4期172-175,共4页Pharmacology and Clinics of Chinese Materia Medica

摘　　要：目的:观察丹参多酚酸盐联合甲钴胺治疗对糖尿病性心肌病患者血清中血管紧张素转化酶2(ACE2)和血管紧张素1-7(Ang-(1-7))含量的影响。方法:将80例糖尿病性心肌病患者随机分为对照组和观察组,每组40例。两组患者均给予甲钴胺等常规药物治疗,观察组加用丹参多酚酸盐治疗。比较两组临床疗效,同时检测患者血清Ang II、ACE2、Ang-(1-7)水平,氧化应激指标MDA和SOD,血糖指标FBG、PBG和Hb A1c,心功能参数EF、PE、PA和E/A等指标变化情况,记录不良反应。结果:观察组治疗总有效率为87.50%,明显高于对照组的65.00%;治疗后,观察组较对照组Ang II水平明显降低,ACE2、Ang(1-7)水平明显升高;治疗后,观察组较对照组SOD水平明显升高,MDA水平均明显降低;治疗后,观察组较对照组FBG、PBG、Hb A1c水平均明显降低;治疗后,观察组较对照组EF、PE、PA、E/A均明显改善;两组不良反应发生率均不明显,对比无差异。结论:丹参多酚酸盐可能通过升高血清ACE2、Ang-(1-7)水平,而发挥抗氧化应激,抗炎症、调节血糖平衡等心功能保护作用,联合甲钴胺治疗糖尿病心肌病,可明显改善患者心功能,提高治疗效果。Objective： To observe the effect of salvianolate combined with mecobalamin on levels of serum ACE2 and Ang-（ 1-7） in patients with diabetic cardiomyopathy. Methods： 80 cases of patients with diabetic cardiomyopathy were randomly divided into the control group and the observation group,40 cases in each group. Both groups were treated with mecobalamin and the observation group was additionally treated with salvianolate. Clinical efficacies were compared between two groups. Levels of serum Ang II,ACE2 and Ang-（ 1-7）,changes of oxidative stress indexes（ MDA,SOD）,blood glucose indexes（ FBG,PBG,Hb A1c） and cardiac function parameters（ EF,PE,PA,E/A） were detected and adverse reactions were recorded. Results： The total effective rate of treatment in the observation group was significantly higher than that in the control group（ 87. 50% vs 65. 00%）（ P〈0. 05）. After the treatment,levels of Ang II,MDA,FBG,PBG and Hb A1 c in the observation group were significantly lower than those in the control group（ P〈0. 05）,while levels of ACE2,Ang（ 1-7） and SOD were significantly higher than those in the control group（ P〈0. 05）. After the treatment,EF,PE,PA,E/A were significantly better in the observation group than those in the control group（ P〈0. 05）. There was no significant difference in the incidence of adverse reactions between two groups（ P〈0. 05）. Conclusion： Salvianolate may play roles of anti-oxidative stress,anti-inflammation and regulating blood glucose balance,and protect cardiac function by increasing levels of serum ACE2 and Ang-（ 1-7）. Its combination with mecobalamin in the treatment of diabetic cardiomyopathy can improve the cardiac function of patients and improve the therapeutic effect.

关 键 词：丹参多酚酸盐 甲钴胺 糖尿病心肌病 血管紧张素转化酶II 血管紧张素-(1-7) 

分 类 号：R542.2[医药卫生—心血管疾病] R587.2[医药卫生—内科学]