| Objective By examining patients vasomotor factor,inflammatory cytokines concentration and peripheral blood endothelial progenitor cells before and after the intervention of Olmesartan.Compare coronary heart disease and coronary heart disease complicated with diabetes mellitus patients with normal controls that changes of endothelial function.To provide experimental evidence for clinical application of coronary heart disease and coronary heart disease complicated with diabetes mellitus.Method 1.Collection of medical records:Collect a total of 160 of eligible cases,according to the coronary angiography and CT of coronary arteries examination results or the WHO put forward the diagnostic criteria of diabetes in 1999 into normal controls groups(N,n=40),simple coronary heart disease groups(C,n=62)and coronary heart disease complicated with diabetes mellitus groups(D,n=58).Then respectively were randomly divided these three groups into Olmesartan treatment group(A)and routine treatment group(B)(NA n=20,NB n=20;CA n=31;CB n=31;DA n=28;DB n=28).2.Baseline data:Before medication,statistics of each group for basic information,including age,sex,body mass index and statistical analysis of whether there is a difference.3.General examination index:Statistics and compare the cases in each group triglycerides,such as blood pressure,LDL-C,fasting blood glucose,2-hour post-meal blood glucose,serum creatinine and urea nitrogen levels,follow-up check again after3 months and compared.4.Experimental detection index:The second day early morning after cases in thegroup draw peripheral blood,part of serum to return with ELISA method to detect the concentration of NO,ET-1,PGI2,TXA2,MCP-1,VCAM-1.Another part of blood with anticoagulation by EDTA after separation of peripheral blood lymphocytes,then detection by flow cytometry to detect peripheral blood endothelial progenitor cells(EPCs)number.Olmesartan treatment after 3 months(not to interfere in healthy control group),perip heral blood again review the above indicators.Result 1.Baseline data comparison:The basic data such as age distribution,sex ratio,and body mass index in each group is no obvious statistical significance(P>0.05).2.General biochemical examination results:Blood pressure levels were approximately the same in all groups before treatment(P>0.05).After 3 months,the blood pressure was significantly lower than that before treatment(P<0.05).Before treatment,the blood lipid level of group C and group D was obviously higher than that of group N(P<0.05),fasting blood glucose and postprandial blood glucose in D group were higher than that of group C and group N(P<0.05),C and N group blood sugar level is not significant,each group of creatinine and urea nitrogen levels without statistical significance.3 months after treatment,the blood lipid in group C and D group were lower than earlier(P<0.05),the blood sugar level in group DA were lower than earlier(P<0.05),and renal function have no obvious change before and after treatment.3.ELISA test results:Before drug intervention,compare the concentrations of ET-1 and TXA2,group C and group D were relatively higher than the group N,and group D increased more significantly than group C(P<0.05);compare the concentrations of NO and PGI2,group C and group D are lower than the group N,and group D decrease more obviously(P<0.05);compare the concentrations of MCP-1and VCAM-1,group C and group D were relatively higher than the group N,and group D increased more obviously(P<0.05).After 3 months of Olmesartan intervention: as the concentrations of ET-1 and TXA2,CA group and DA group were lower than 3 months ago,and NO and PGI2 levels are increased,the concentration of MCP-1 and VCAM-1 were lower than 3 months ago(P<0.05);CB group,DB group,NA group and NB group of the vasomotor factor and inflammatory factor were no obvious difference compare with 3 months ago(P>0.05).4.Flow cytometry test EPCS:Before treatment,the number of EPCs in peripheral blood of C group and D group was lower than that in N group(P<0.05).The numberof EPCs have no difference between before and after treatment in the CB group,DB group,NA group and NB group,calculated without statistical significance(P>0.05);The CA group and DA group have better number of EPCs in peripheral blood increased after Olmesartan intervention(P<0.05).Conclusion Patients with coronary artery disease happens endothelial dysfunction,abnormal blood sugar may increase vascular endothelial dysfunction,and Olmesartan protection with endothelial cells,can promote endothelial progenitor cells,inhibits endothelial cell dysfunction and inflammation.Especially for protective effects of hyperglycemia in patients with Olmesartan vascular endotheial is more important. |
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