罗格列酮对2型糖尿病患者颈动脉内膜中层厚度及血清可溶性血管细胞黏附分子-1水平的影响

摘要

Objective To investigate the change of carotid intima - media thickness ( IMT ) and serum soluble vascular cell adhesion molecule -1 ( sVCAM -1 ) levels in Type 2 diabetic patients, and to assess the effect of rosiglitazone on IMT and sVCAM - 1 levels.Methods In this study 108 cases of Type 2 diabetic patients were randomly divided into treatment group and control group, every group consisted of 54 numbers.The control group received routine therapy alone.The treatment group was treated with rosightazone 4 mg/d on the basis routine therapy for six months.Serum level of sVCAM - 1, plasma glucose and IMT were measured before and after rosiglitazone intervention on two groups, to observe the differences after treatment between the groups with rosiglitazone treatment and without rosiglitazone treatment Results The level of plasma glucose in Type 2 diabetic patients was significantly lower than that before treatment ( P ＜ 0.05 ).After treatment with rosiglitazone, IMT and serum sVCAM - 1 levels decreased significantly ( P ＜0.05 ).There was no obvious change in IMT and serum sVCAM - 1 levels in control group before and after the treatment ( P ＞ 0.05 ).Using multile linear stepwise regression analysis, the significant correlation between IMT and sVCAM - 1, BMI, 2 hPG, HOMA -IR were discovered ( P ＜0.01 ).Conclusion there is closely relationship between serume sVCAM - 1 levels and Type 2 diabetic macrovascular disease.Serum sVCAM - 1 can be reduced significantly in the Type 2 diabetic patients after being treated with rosiglitazone, which may be one of the protective mechanisms of vascular vessels.%目的 观察2型糖尿病(T2DM)患者血清可溶性血管细胞黏附分子-1(sVCAM-1)水平和颈动脉内膜中层厚度(IMT)的变化,以及罗格列酮治疗对二者的影响.方法 将108例T2DM患者随机分为治疗组(54例)和对照组(54例).治疗组在原治疗基础上给予罗格列酮4 mg/d.治疗前和治疗6个月后检测血生化指标、IMT及血清sVCAM-1水平,并与对照组进行比较.结果 两组患者治疗后血糖均显著下降,差异有统计学意义(P＜0.05);治疗组治疗后IMT和sVCAM-1水平均较治疗前显著降低,差异有统计学意义(P＜0.05);对照组治疗后IMT和sVCAM-1水平与治疗前比较,差异无统计学意义(P＞0.05).多元线性逐步回归分析显示,IMT与sVCAM-1、BMI、2 hPG和HOMA-IR有关(P＜0.01).结论 血清sVCAM-1水平与T2DM早期大血管病变关系密切;罗格列酮能显著降低T2DM患者血清sVCAM-1水平,这可能是罗格列酮血管保护的作用机制之一.