摘要
目的探讨2型糖尿病(T2DM)患者血清一氧化氮(NO)、内皮素(ET)和C反应蛋白(C-RP)的变化及卡托普利对其影响。方法120例T2DM患者随机分为常规治疗组和卡托普利组,卡托普利组在常规治疗基础上加卡托普利。分别测定治疗前及治疗1、2、3、6个月后血清NO、ET和C-RP,以50例正常人为对照。结果T2DM患者血清NO浓度显著低于对照组(23±6μmol/L比37±8μmol/L,P<0·05),ET含量明显高于对照组(94±19μg/L比57±14μg/L,P<0·05),C-RP浓度显著高于对照组(4·6±2·1mg/L比2·3±1·2mg/L,P<0·05)。卡托普利组治疗2个月后NO浓度显著上升(23±7μmol/L比29±6μmol/L,P<0·05),ET显著下降(95±19μg/L比80±22μg/L,P<0·05),3个月后C-RP也显著下降(4·7±1·3mg/L比3·3±1·1mg/L,P<0·05);常规治疗组6个月观察期内NO、ET和C-RP无明显变化。结论T2DM患者存在着血管内皮功能受损和动脉内膜的慢性炎症反应,卡托普利可减轻T2DM患者的内皮功能受损和慢性炎症反应。
Objective To investigate the changes of serum nitric oxide （NO）, endothelin（ET） and C-reactive protein（CRP） in patients with type 2 diabetes mellitus and the effect of captopril on the changes. Methods 120 type 2 diabetic subjects were randomly assigned into conventional （CV） treatment group and captopril （CP） group. The captopril group was given captopril in addition to conventional treatment. The serum NO, ET and CRP concentration were measured before and 1,2,3 and 6 months after treatment, which were compared with those in 50 normal control （NC）. Results The level of NO was significantly lower （23± 6 vs 37± 8 μmol/L）, while the levels of ET and CRP significantly higher in type 2 diabetic subjects than those in NC group （94±19 vs 57±14 μg/L,and 4. 6± 2.1 vs 2.3± 1.2 mg/L,all P〈0. 05）. In the CP group after 2 months treatment the NO level increased significantly （ from 23±7 to 29±6 μmol/L, P〈0. 05） and the level of ET decreased significantly （from 95± 19 to 80± 22 μg/L, P〈0.05）. After 3 months treatment, the level of CRP decreased significantly （from 4.7±1.3 to 3.3±1.1 mg/L,P〈0. 05）. In CV group, the levels of NO, ET and CRP didn＇t significantly change in a preiod of 6 months＇ following-up. Conclusion Endothelial dysfunction and chronic inflammation within the vascular intima are present in patients with type 2 diabetes mellitus. Captopril improves the endothelial dysfunction and reduces the inflammation in the intima.
