α-硫辛酸对糖尿病合并下肢动脉血管病变患者血管舒张功能及血清氧化应激因子的影响  

Effect of α-lipoic acid on vasodilatation and serum oxidative stress factor in patients with diabetes mellitus complicated with lower extremity arterial disease

作　　者：冯光勇[1] 黄伟[1] 

机构地区：[1]武汉科技大学附属普仁医院内分泌科,湖北武汉430081

出　　处：《新乡医学院学报》2016年第12期1062-1066,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨α-硫辛酸对糖尿病合并下肢动脉血管病变患者血管舒张功能及血清氧化应激因子的影响。方法 120例糖尿病合并下肢动脉血管病变(DLEAD)患者按照随机数字表法分为硫辛酸组40例、前列地尔组40例和丹参组40例。在常规治疗的基础上,硫辛酸组患者给予硫辛酸0.6 g,静脉滴注,每日1次,前列地尔组患者给予前列地尔10μg,静脉滴注,每日1次,丹参组患者给予丹参注射液40 m L,静脉滴注,每日1次,3组患者均治疗3周。采用行走受损问卷(WIQ)评价患者日常活动能力,彩色多普勒超声检查舒张末期肱动脉内径,并计算血管扩张功能(FMD),同时检测患者血清丙二醛(MDA)、谷胱甘肽(GSH)、白细胞介素-6(IL-6)、纤溶酶原激活物抑制物-1(PAI-1)水平。结果 120例患者实际收集有效病例118例,其中硫辛酸组39例,前列地尔组40例,丹参组39例。3组患者治疗前WIQ评分、肱动脉内径、FMD、足背动脉血流速度、血流量、血清GSH、MDA、IL-6、PAI-1水平比较差异均无统计学意义(P>0.05)。治疗2、3周后,3组患者足背动脉血流速度与治疗前比较差异均无统计学意义(P>0.05),WIQ评分、肱动脉内径、FMD、足背动脉血流量、血清GSH水平均显著高于治疗前(P<0.05),血清MDA、IL-6、PAI-1水平均显著低于治疗前(P<0.05);治疗3周WIQ评分、肱动脉内径、FMD、足背动脉血流量、血清GSH水平均显著高于治疗2周(P<0.05),血清MDA、IL-6、PAI-1水平显著低于治疗2周(P<0.05)。治疗3周硫辛酸组患者WIQ评分、肱动脉内径、FMD、足背动脉血流量、GSH水平显著高于同时段前列地尔组和丹参组(P<0.05),MDA、IL-6、PAI-1水平显著低于同时段前列地尔组和丹参组(P<0.05)。结论α-硫辛酸能提高下肢血管舒张功能,其作用机制可能与降低患者体内氧化应激水平、缓解炎症反应有关。Objective To explore the effect of α-lipoic acid on vasodilatation and serum oxidative stress factor in patients with diabetes mellitus complicated with lower extremity arterial disease. Methods A total of 120 patients with diabetic lower extremity arterial disease( DLEAD) were divided into lipoic acid group( n = 40),alprostadil group( n = 40) and Danshen group( n = 40) according to the random number table method. Based on the conventional therapy,the patients in lipoic acid group,alprostadil group and Danshen group were treated with 0. 6 g lipoic acid,10 μg alprostadil and 40 m L Danshen injection by intravenous drip respectively; once a day for three weeks. The ability of daily activities was evaluated by walking impairment questionnaire( WIQ). The diameter of end-diastolic brachial artery was measured by color doppler ultrasound,and the flow-mediated dilation( FMD) was calculated. The levels of serum malondialdehyde( MDA),glutathione( GSH),interleukin-6( IL-6)and plasminogen activator inhibitor-1( PAI-1) were detected. Results A total of 118 cases were collected effectively from the120 patients,including 39 cases in lipoic acid group,40 cases in alprostadil group and 39 cases in Danshen group. There was no significant difference in the WIQ score,brachial artery diameter,FMD,blood flow velocity and blood flow of dorsal pedis artery,the levels of serum GSH,MDA,IL-6 and PAI-1 among the three groups before treatment( P > 0. 05). There was no significant difference in the blood flow velocity of dorsal pedis artery before treatment and two and three weeks after treatment in the three groups( P > 0. 05). Compared with prior treatment,the WIQ score,brachial artery diameter,FMD,blood flow of dorsal pe-dis artery and serum GSH level were higher; and the levels of serum MDA,IL-6 and PAI-1 were lower after two and three weeks treatment in the three groups( P < 0. 05). Compared with two weeks after treatment,the WIQ score,brachial artery diameter,FMD,blood flow of dorsal pedis artery and serum GSH level were higher; and

关 键 词：Α-硫辛酸 前列地尔 丹参注射液 糖尿病下肢动脉血管病变 血管舒张功能 氧化应激 

分 类 号：R587.2[医药卫生—内分泌]