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目的观察血脂正常的老年2型糖尿病患者经辛伐他汀短期强化治疗前后体内核因子κB活性及血浆炎症相关因素的变化,评估其对老年2型糖尿病及其大血管并发症患者的保护作用。方法 64例老年2型糖尿病患者,男女各32例,口服辛伐他汀40mg/d治疗2周,治疗前后分别检测核因子κB活性及血浆炎症因子水平、CRP、外周血单个核细胞计数。结果①大血管病变组年龄、糖尿病病程、空腹血糖、血肌酐、24 h尿微量白蛋白、收缩压、核因子κB活性、血浆炎症相关指标CRP、外周血单个核细胞计数、炎症因子IL-6、TNF-α明显高于无大血管病变组,血浆炎症抑制因子IL-10水平明显低于无大血管病变组;②老年2型糖尿病及其大血管并发症患者经辛伐他汀短期强化治疗后血浆炎症因子IL-6、TNF-α、CRP、外周血单个核细胞计数明显降低;血浆炎症抑制因子IL-10水平明显升高。结论老年2型糖尿病患者血浆CRP水平、外周血单个核细胞计数明显增高,处于炎症状态。辛伐他汀短期强化治疗能显著减低2型糖尿病患者血浆CRP、外周血单个核细胞计数、核因子κB活性、炎症因子IL-6、TNF-α水平,上调血浆炎症抑制因子IL-10水平。这为老年2型糖尿病患者使用辛伐他汀预防心脑血管疾病提供临床证据。
Objective To observe the changes of nuclear factor κB (NF-κB) activity and the related factors of plasma inflammation before and after short-term intensive chemotherapy with simvastatin in elderly patients with type 2 diabetes mellitus with normal blood lipids to evaluate its protective effect on type 2 diabetes mellitus and its macrovascular complications. Methods Sixty-four elderly patients with type 2 diabetes mellitus (32 males and 32 females) were treated with 40 mg / d simvastatin orally for 2 weeks. The levels of NF-κB, plasma levels of inflammatory cytokines and CRP and mononuclear cells were measured before and after treatment. Results ① The age, duration of diabetes, fasting blood glucose, serum creatinine, 24h urine microalbumin, systolic blood pressure, nuclear factor κB activity, plasma inflammatory markers CRP, peripheral blood mononuclear cell count, inflammatory cytokines IL-6 , TNF-α was significantly higher than those without macrovascular disease, plasma inflammatory cytokines IL-10 levels were significantly lower than those without macrovascular disease group; ② elderly type 2 diabetes mellitus and its macrovascular complications after simvastatin short-term intensive treatment Plasma inflammatory cytokines IL-6, TNF-α, CRP, peripheral blood mononuclear cell count was significantly lower; plasma inflammatory cytokines IL-10 levels were significantly higher. Conclusion In elderly patients with type 2 diabetes plasma CRP levels, peripheral blood mononuclear cell count was significantly increased, in an inflammatory state. Simvastatin short-term intensive treatment can significantly reduce type 2 diabetes patients with plasma CRP, peripheral blood mononuclear cell counts, nuclear factor κB activity, inflammatory cytokines IL-6, TNF-α levels, upregulation of plasma inflammatory cytokines IL-10 levels. This provides clinical evidence for the use of simvastatin in the prevention of cardiovascular and cerebrovascular diseases in elderly patients with type 2 diabetes.