普罗布考对糖尿病大血管病变患者颈动脉内中膜厚度及氧化应激的影响

摘要

目的 探讨普罗布考对糖尿病大血管病变患者颈动脉内中膜厚度及血清氧化应激水平的影响.方法 选取健康志愿者作为正常对照组(N组,n=30),将80例糖尿病大血管病变患者随机分为常规治疗组(C组,n=40)普罗布考组(P组,n=40).P组在常规治疗基础上加用普罗布考250 mg,2次/d,疗程6个月.治疗前及治疗后6个月分别进行颈动脉彩色多普勒超声检查颈动脉内中膜厚度,并留取血清检测血脂,酶联免疫吸附法检测8-异前列腺素F2α(8-iso-PGF2α)、氧化低密度脂蛋白(OX-LDL)水平.结果 (1)与N组相比,糖尿病大血管病变C组和P组患者的血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)均显著升高,高密度脂蛋白(HDL)下降,8-iso-PGF2α、OX-LDL显著升高,颈动脉内中膜厚度增加,差异均有统计学意义(P＜0.05).(2)C组治疗后TC、TG、LDL、8-iso-PGF2α、OX-LDL均呈下降趋势,但差异无统计学意义(P＞0.05),颈动脉内中膜厚度无明显改变.P组经治疗后TC、TG、LDL、8-iso-PGF2α、OX-LDL均降低,差异有统计学意义(P＜0.05);颈动脉内中膜厚度无统计学差异(P＞0.05),但呈现下降趋势.结论 普罗布考在调节血脂的同时,可改善糖尿病大血管病变患者体内氧化应激水平并有减少颈动脉内中膜厚度的趋势.%Objective To investigate the effect of probucol on oxidative stress state and carotid intimal medial thickness of patients with type 2 diabetic macroangiopathy. Methods A total of 30 health volunteer were recruited as the normal control group ( group N, n = 30 ), and 80 patients with type 2 diabetic macroangiopathy were randomly devided as conventional therapy group ( group C, n =40 ) and probucol group ( group P, n =40 ). The patients in group P were treated by conventional therapy plus prubucal 250 mg twice a day for a course of 6 months. The levels of serum blood fat, 8 - iso - prostaglandin F 2alpha ( 8 - iso - PGF2α ) and oxidized low - density lipoprotein ( OX - LDL ) ( enzyme linked immunosorbent assay ), and the carotid intimal medial thickness ( IMT ) ( color Doppler ultrasonography ) were measured before and after 6 months treatment. Results ( 1 ) Compared with the group N, the levels of total cholesterol ( TC ), triglyceride ( TG ). low density lipoprotein ( LDL ), 8 -iso - PGF2α , OX - LDL and IMT in group C and group P were significantly increased, however the level of HDL were decreased ( all P ＜ 0. 05 ). ( 2 ) Compared with pre - therapy, the levels of TC, TG, LDL, 8 -iso - PGF2α, and OX - LDL presented a trend of decrease though with no statistics meaning ( P ＞ 0. 05 ), and IMT had no evident change ; while the levels of TC, TG,LDL, 8 - iso - PGF2α , and OX - LDL in group P decreased ( P ＜ 0. 05 ). Conclusion Probucol can improve blood fat, it can also decrease oxidative stress state, and of a tendency to reduce IMT of patients with type 2 diabetic macroangiopathy.