| Objective Observe the changes of soluble intercellular adhesion molecule,oxidizedlow-density lipoprotein,8-iso-prostaglandinF2alpha, interleukin-6,Tumor necrosisfactor alpha,ankle-brachial index score,and clinical symptoms as well as impact ofalprostadil injection in patients of diabetic lower extremity arterial disease. To explorethe relationship among oxidative stress, adhesion molecules, inflammatory factors aswell as other metabolic indicators in diabetic lower extremity arterial disease, andprovide the basis for the prevention and treatment of diabetic lower extremity vasculardisease.Methods Randomly selected80patients with type2diabetes (T2DM) from September2011to February2012in the Beijing Military Region General Hospital. According to theankle-brachial index (ABI), patients with T2DM were divided into without lowerextremity vascular disease (group A, n=40) and lower extremity vascular disease (groupB, n=40). Patients with extremity vascular disease were divided into alprostadiltreatment group (group B1) and conventional treatment group (group B2), and electedage and sex-matched healthy control group (NC group)40cases. The conventionaltreatment group was treated with conventional antidiabetic, antihypertensive,lipid-lowering therapy, while alprostadil treatment group on the basis of conventionaltherapy was plused alprostadil injection (alprostadil injection10ug dissolved in10ml ofnormal saline intravenous injection or infusion infusion directly into a small pot,1times/d, treat for14ds). Detected fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL-C),high density lipoprotein (HDL-C), soluble intercellular adhesion molecule (sICAM-1),the oxidative modification of low-density lipoprotein (Ox-LDL),8-isoprostane F2alpha(8-iso-PGF2alpha), interleukin-6(IL-6), tumor necrosis factor-alpha (TNF-alpha)and other metabolic markers in all subjects. Reviewed of the indicators in diabetic lowerextremity vascular disease after14days’ treatment.Results1.The age and gender composition in NC group and T2DM group had nostatistical significant difference(p>0.05), FPG, HbA1c, TG, TC, LDL-C,sICAM-1,Ox-LDL,8-iso-PGF2alpha, IL-6and TNF-alpha level was significantly increased inT2DM group,while HDL-C was decreased significantly, and the difference s werestatistically significant (p <0.05).2.The age, gender composition, FPG, HbA1c, TG, TC, LDL-C and HDL-C had nostatistical significant difference(p>0.05) in T2DM A group and B group. In group B,sICAM-1, Ox-LDL,8-iso-PGF2alpha, IL-6, TNF-alpha level and clinical symptomscore were significantly increased, whike the ABI was decreased significantly, and thedifferences were statistically significant (p <0.05).3.sICAM-1, Ox-LDL,8-iso-PGF2alpha, clinical symptom score was significantly lowercompared with the conventional treatment group, while ABI increased statisticallysignificantly(p <0.05) in patients with diabetic lower extremity vascular disease andalprostadil treatment group after14days’ treatment. IL-6, TNF-alpha level in the twogroups had no statistically significant difference before and after treatment (p>0.05).4.Ox-LDL,8-iso-PGF2alpha, IL-6, TNF-alpha and other biomarkers with the course ofthe disease, LDL-C, clinical symptom score,8-iso-PGF2alpha, sICAM-1, IL-6,TNF-alpha into a positive correlation (P <0.05), ABI and HDL-C were negativelycorrelated (P <0.05). Ox-LDL,8-iso-PGF2α, sICAM-1, IL-6, TNF-α as the dependentvariable, while disease duration, HbA1c, FPG, TG, TC, LDL-C, HDL-C,8-iso-the PGF2α, sICAM-1, IL-6, TNF-α, ABI, clinical scores as independent variables, multiple linearregression analysis, the regression equation: Ox-LDL=-1.375+0.013TNF-α+0.5938-iso-PGF2α;8-iso-PGF2=3.305+0.266Ox-LDL-0.325HDL+0.027IL-6; sICAM-1=73.449+20.594IL-6+2.797TNF-α; IL-6=-22.568+0.016sICAM-1+6.8098-iso-PGF2α+2.309HDL; TNF-α=-20.149+29.352Ox-LDL+0.066sICAM-1.Conclusions1. Regardless of the presence of lower extremity vascular disease or not,sICAM-1, Ox-LDL,8-iso-PGF2alpha, IL-6, TNF-alpha had significantly increased intype2diabetic patients. Compared to without lower extremity vascular disease, sICAM-1,Ox-LDL,8-iso-PGF2alpha, IL-6, TNF-alpha level was significantly higher while theABI significantly lower in T2DM patients with lower extremity vascular disease.2.Alprostadil can significantly reduce the level of oxidative stress and cell adhesionmolecules in diabetic patients with lower extremity vascular disease, and to improvelower limb blood flow and clinical symptoms, but can not reduce the level of IL-6andTNF-alpha.3.The occurence of diabetic patients with lower extremity vascular disease has related toenhancement of oxidative stress, adhesion molecules and inflammatory factors. |
PDF Full Text Request