吡格列酮对不稳定型心绞痛合并糖尿病患者内皮祖细胞数量及脂联素水平的影响

摘要

目的：探讨吡格列酮对不稳定型心绞痛（UAP）合并2型糖尿病患者内皮祖细胞（EPCs）数量及脂联素水平的影响。方法入选自2010年6月至2011年5月在湖北医药学院附属太和医院住院的有UAP合并2型糖尿病患者57例，随机分为吡格列酮组（n=28）和对照组（n=29），吡格列酮组应用吡格列酮（30 mg/d）治疗，对照组患者不使用噻唑烷二酮类药物。治疗前及治疗12周时通过流式细胞技术双色分析法检测所有患者外周血中EPCs占有核细胞的百分比，其中EPCs用CD34+/KDR+双标记定位，比较两组患者在干预前后内皮祖细胞数量的变化及血清脂联素水平的变化。结果两组患者在治疗前EPCs的数量无统计学差异（P＞0.05）。治疗12周时，吡格列酮组患者EPCs数量较治疗前明显增加（0.023±0.010 vs.0.051±0.012，P＜0.01）；对照组患者EPCs数量在治疗前后无统计学差异（P＞0.05）；12周时，吡格列酮组患者EPCs数量高于对照组患者（P＜0.028）。吡格列酮组血清脂联素水平在治疗前、后有统计学差异（P＜0.05）；对照组患者血脂联素水平在治疗前、后无统计学差异（P＞0.05）；12周时，吡格列酮组患者血清脂联素水平高于对照组患者（P＜0.05）。结论吡格列酮能够促进冠心病合并糖尿病患者EPCs的动员，提高患者血清脂联素水平。%Objective To investigate the influences of pioglitazone on quantity of endothelial progenitor cells (EPCs) and adiponectin level in patients with unstable angina pectoris (UAP) complicating type 2 diabetes mellitus (T2DM). Methods The patients (n=57) were randomly divided into pioglitazone group (n=28) and control group (n=29), and pioglitazone group was treated with pioglitazone (30 mg/d) and control group was not given TZD drugs. The percentage of peripheral EPCs in karyocytes was detected by using flow cytometry and double color analysis before treatment and 12 w after treatment, and EPCs were localized with CD34+/KDR+double labeling. The changes of quantity of EPCs and level of serum adiponectin were compared between 2 groups before and after treatment. Results The quantity of EPCs had no statistical difference between 2 groups before treatment (P>0.05). After treatment for 12 w, the quantity of EPCs increased significantly in pioglitazone group (0.023±0.010 vs. 0.051 ±0.012, P<0.01), and had no statistical difference in control group (P>0.05). The quantity of EPCs was higher in pioglitazone group than that in control group 12 w after treatment (P<0.028). The level of serum adiponectin had statistical difference in pioglitazone group before and after treatment (P<0.05), while had no statistical difference in control group (P>0.05). The level of serum adiponectin was higher in pioglitazone group than that in control group 12 w after treatment (P<0.05). Conclusion Pioglitazone can improve the mobilization of EPCs and level of serum adiponectin in patients with UAP complicating T2DM.