CAJ | 학술논문

目的观察2型糖尿病患者阿卡波糖治疗4周前后血中炎症因子水平的变化.方法随机选取符合入选标准的2型糖尿病患者118例.患者按照随机数字表法进入A组(糖尿病阿卡波糖治疗组)58例,给予阿卡波糖150mg/d;进入B组(糖尿病对照组)60例,不服用阿卡波糖,其余治疗与A组相似,为实现血糖达标,调节除阿卡波糖之外的降糖药及胰岛素用量;57名健康个体作为C组(健康人群对照组).A、B 2组糖尿病患者均采集入组时和干预治疗4周后的空腹血清,C组采集一次空腹血清,于-80℃冰箱保存待测(排除不合格血清标本,如溶血、样本量不足等,最终进入A组实际检测人数为57例,B组为59例).监测3餐前、餐后2 h末梢血糖,测定生化指标,用ELISA法测定血清单核细胞趋化蛋白-1(MCP-1)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、血浆纤溶酶原激活物抑制物-1(PAI-1)、脂多糖水平,用荧光光谱法测定晚期糖基化指数(AGI)水平来表示晚期糖基化终末产物(AGEs)的相对含量.结果干预治疗后,两组糖尿病患者的空腹血糖、HbA1C均显著降低(P＜0.05).A组治疗后各炎症因子水平MCP-1、脂多糖、AGI、hs-CRP、TNF-α均显著降低(P＜0.05),而PAI-1无显著下降(P=0.163).B组治疗后MCP-1、脂多糖、AGI、TNF-α和PAI-1水平均升高,hs-CRP水平下降(P＜0.05).与B组比较,A组MCP-1、脂多糖、PAI-1、TNF-α、AGI治疗前后水平下降趋势更明显.A、B两组的hs-CRP在干预前后的变化趋势差异无统计学意义(P＞0.05).结论糖尿病患者炎症因子水平高于健康人群,阿卡波糖干预治疗可显著降低其部分炎症因子的水平.
목적 관찰2형당뇨병환자아잡파당치료4주전후혈중염증인자수평적변화.방법 수궤선취부합입선표준적2형당뇨병환자118례.환자안조수궤수자표법진입A조(당뇨병아잡파당치료조)58례,급여아잡파당150mg/d;진입B조(당뇨병대조조)60례,불복용아잡파당,기여치료여A조상사,위실현혈당체표,조절제아잡파당지외적강당약급이도소용량;57명건강개체작위C조(건강인군대조조).A、B 2조당뇨병환자균채집입조시화간예치료4주후적공복혈청,C조채집일차공복혈청,우-80℃빙상보존대측(배제불합격혈청표본,여용혈、양본량불족등,최종진입A조실제검측인수위57례,B조위59례).감측3찬전、찬후2 h말소혈당,측정생화지표,용ELISA법측정혈청단핵세포추화단백-1(MCP-1)、종류배사인자-α(TNF-α)、초민C반응단백(hs-CRP)、혈장섬용매원격활물억제물-1(PAI-1)、지다당수평,용형광광보법측정만기당기화지수(AGI)수평래표시만기당기화종말산물(AGEs)적상대함량.결과 간예치료후,량조당뇨병환자적공복혈당、HbA1C균현저강저(P＜0.05).A조치료후각염증인자수평MCP-1、지다당、AGI、hs-CRP、TNF-α균현저강저(P＜0.05),이PAI-1무현저하강(P=0.163).B조치료후MCP-1、지다당、AGI、TNF-α화PAI-1수평균승고,hs-CRP수평하강(P＜0.05).여B조비교,A조MCP-1、지다당、PAI-1、TNF-α、AGI치료전후수평하강추세경명현.A、B량조적hs-CRP재간예전후적변화추세차이무통계학의의(P＞0.05).결론 당뇨병환자염증인자수평고우건강인군,아잡파당간예치료가현저강저기부분염증인자적수평.
Objective To evaluate the effect of acarbose on the circulating concentration of inflammatory factors in patients with type 2 diabetes mellitus(T2DM). Methods Total 118 patients with T2DM who did not take acarbose before enrollment within 4 weeks were recruited by a randomizing formula into 2 groups ( group A and B). 57 healthy subjects were included into group C as control. After excluding those of inadequate samples, 57 patients with T2DM were enrolled into group A in which acarbose was prescribed 50 mg three times a day, 59 patients with T2DM were enrolled into group B in which acarbose was not given and other hypoglycemic approaches were similar to group A. Serum samples at the time of enrollment and at the end of 4 weeks intervention were collected and stored in refrigerator at -80℃ until analysis. Analysis of biochemical indexes was performed in central lab of the institution,inflammatory factors were determined with commercial ELISA kits. Results (1) The metabolic indexes were significantly decreased after intervention in two diabetic groups. (2) The baseline levels of monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-α( TNF-α), prothrombin activator inhibitor-1 (PAI-1), lipopolysaccharide (LPS), high sensitive C reactive protein ( hs-CRP), and advanced glycation index (AGI) in diabetic patients were significantly higher than in group C MCP-1 [( 463.4± 187.1 vs 267.1 ± 158.3 ) pg/ml, TNF-α( 12.07 ± 19.59 vs 4.18 ±3.03 ) pg/ml, PAI-1 ( 2.47 ± 1.87 vs 1.38 ± 2.37 )ng/ ml, LPS ( 130.6 ± 128.5 vs 29.39 ± 17.93 ) pg/ml, hsCRP(4.25 ±2.29 vs 2.11 ± 1.07 ) μg/ml, AGI (3.78 ± 2.61 vs 0. 74 ± 0. 15 ) AU, all P ＜ 0. 05]. (3) Repeated measurement ANOVA analysis showed that after four weeks of intervention, MCP-1 [F( 1,106 ) = 19. 830, P＜0.001],LPS[F(1,106)=7.815, P＜0.01], PAI-1 [F(1,106)= 7.792, P＜0.01], TNF-α[F(1,106=24. 656, P=0.001 )] ,AGI[F( 1,106)= 12. 971 ,P=0. 01] decreased significantly in group A than in group B. Although hsCRP decreased in both group A and group B, but the trend was not different [F( 1,102 )= 0. 915, P = 0. 342].Conclusion The levels of inflammatory factors were elevated in patients with type 2 diabetes mellitus, which could be mostly reduced by acarbose.