贝前列素钠治疗老年糖尿病周围神经病变患者的临床疗效及对血清一氧化氮和内皮素-1水平的影响  

The effectiveness of Beraprost sodium in elderly patients with diabetic peripheral neuropathy and its influence on serum nitric oxide and endothelin-1 levels

作　　者：李洁[1] 安丽[1] 任利群[1] Li Jie;An Li;Ren Liqun(Department of Geriatrics, Zhongda Hospital, Southeast University , Nanjing 21009 , China)

机构地区：[1]东南大学附属中大医院老年科,南京210009

出　　处：《中华老年医学杂志》2018年第4期420-422,共3页Chinese Journal of Geriatrics

摘　　要：目的观察贝前列素钠治疗老年糖尿病周围神经病变患者的疗效以及对血管内皮功能失调的影响。方法选取2014年4月至2016年5月在我院老年病科住院的糖尿病周围神经病变患者86例（≥60岁），经多普勒超声检查排除合并下肢动脉闭塞症患者（狭窄部位直径〉50%）。随机分为对照组（43例）及治疗组（43例），两组均常规应用降糖、降脂、抗血小板及营养神经等基础药物治疗及戒烟、足部保健等非药物治疗，治疗组加用贝前列素钠40 μg/次，3次/d，口服，疗程90 d。观察两组治疗前后下肢平均振动感觉阈值、经皮氧分压（tcpO2）、踝肱指数（ABI）、血清一氧化氮（NO）和内皮素-1（ET-1）水平的变化。结果两组患者均未发生严重不良反应。治疗90 d后，对照组、治疗组下肢平均振动感觉阈值较治疗前均降低（F＝23.06、195.13，均P〈0.01）；两组足背tcpO2、ABI指数较治疗前相比升高（对照组F＝304.65、119.24，均P〈0.01；治疗组F＝594.33、336.60，均P〈0.01）；对照组和治疗组血清NO水平较治疗前相比升高（F＝375.48、741.20，均P〈0.01），两组血清ET-1水平较治疗前相比降低（F＝49.07、211.24，均P〈0.01）。治疗90 d后，治疗组下肢平均振动感觉阈值较对照组降低（F＝25.16，P〈0.01），足背tcpO2、ABI指数高于对照组（F＝62.82、21.46，均P〈0.01）；治疗组血清NO水平高于对照组（F＝24.06，P〈0.01），血清ET-1水平低于对照组（F＝61.83，P〈0.01）。结论口服贝前列素钠治疗老年糖尿病周围神经病变疗效显著，安全性良好，并可以有效改善其血管内皮功能。ObjectiveTo evaluate the effectiveness of Beraprost sodium and its impact on vascular endothelial dysfunction in elderly patients with diabetic peripheral neuropathy （DPN）.MethodsA total of 86 elderly patients （age≥60 years） with DPN were recruited and randomly assigned into a control group （n=43） and a treatment group （n=43）. Both groups received regular treatments including drug treatment such as glucose-lowering, lip-lowering, anti-platelet and neurotropic medications, and non-drug treatment measures such as smoking cessation and foot massage.In addition, the treatment group was given 40 μg oral Beraprost sodium three times a day for 90 days.Data on vibrating perception threshold （VPT）, transcutaneous oxygen （tcpO2）, ankle-brachial index （ABI）, liver and kidney function, hemoglobin A1c （HbA1c）, serum nitric oxide （NO） and endothelin-1 （ET-1） were collected before and after treatment.ResultsNo adverse reaction was observed during the experiment.After 90-day treatment, both the control group and the treatment group showed decreased VPT values （F=23.06, 195.13, both P〈0.01）, increased tcpO2 values （F=304.65, 594.33, both P〈0.01）, increased ABI （F=119.24, 336.60, both P〈0.01）, increased serum NO levels （F=375.48, 741.20, both P〈0.01）, and decreased serum ET-1 levels （F=49.07, 211.24, both P〈0.01）. Compared with the control group, the value of VPT （F=25.16, P〈0.01） and the level of ET-1（F=61.83, P〈0.01） were significantly lower, while the level of NO and the values of tcpO2 and ABI were significantly higher （F=24.06, 62.82, 21.46, all P〈0.01） in the treatment group.ConclusionsOral beraprost sodium can be effectively and safely used in DNP patients, and it can also alleviate endothelial dysfunction.

关 键 词：糖尿病 周围神经病 一氧化氮 贝前列素钠 内皮素-1 

分 类 号：R587.2[医药卫生—内分泌]