论文部分内容阅读
目的比较观察老年糖尿病(DM)、老年糖尿病肾病(DN)和健康老年人之间血清14,15-环氧二十碳三烯酸(14,15-EET)的代谢产物14,15-双羟二十碳三烯酸(14,15-DHET)的含量变化,并分析与血管内皮舒张功能障碍的相关性。方法 196例志愿者和患者分为3组:健康老年人组(A组)60例、老年DM组(B组)78例和老年DN组(C组)58例,每组男、女匹配。应用酶联法检测3组血清中14,15-DHET、前列环素(PGI2)代谢产物6-keto-PGF1α和血栓素TXA2代谢产物TXB2的含量,同时检测血糖、血脂等生化指标。采用彩色多普勒超声仪对肱动脉基础内径、血管内皮依赖性舒张功能(EDV)和硝酸甘油介导的血管内皮非依赖性舒张功能(NEDV)进行测定。结果 B组和C组分别与A组比较:(1)血清14,15-DHET和6-keto-PGF1α含量下降(P<0.01),TXB2含量升高(P<0.01);(2)TXB2/6-keto-PGF1α比值和TXB2/14,15-DHET比值升高(P<0.01);(3)糖化血红蛋白(HbA1c)、三酰甘油(TG)和总胆固醇(TC)、尿白蛋白排泄量(UAE)均升高(P<0.01);(4)EDV和NEDV降低(P<0.01)。(5)14,15-DHET含量与DM病程、HbA1c、UAE、TXB2、TXB2/6-keto-PGF1α比值和TXB2/14,15-DHET比值负相关,与EDV和NEDV正相关。结论老年DM和老年DN患者血清中血管内皮依赖性的舒血管因子代谢产物14,15-DHET含量下降发生在DM早期阶段。与PGI2一样,14,15-DHET含量变化可作为判断DM、DN相关的血管EDV和NEDV功能受损的重要指标之一。
Objective To compare the effects of 14,15-dihydroxytetrahydroxyvitamin (14,15-EET), a metabolite of 14,15-epoxyeicosatrienoic acid (14,15-EET) between senile diabetic (DM), senile diabetic nephropathy (DN) and healthy elderly Changes in the content of eicosatrienoic acid (14,15-DHET), and analysis and vascular endothelial dysfunction. Methods A total of 196 volunteers and patients were divided into 3 groups: 60 healthy elderly group (A group), 78 elderly group (B group) and 58 elderly group (C group). Serum 14,15-DHET, PGI2 metabolites 6-keto-PGF1alpha and thromboxane TXA2 metabolites TXB2 were detected by enzyme-linked immunosorbent assay (ELISA), and the biochemical indexes such as blood glucose and blood lipid were detected. The basal diameter of brachial artery, endothelium-dependent vasodilation (EDV) and nitroglycerin-mediated endothelium-independent vasodilatation (NEDV) were measured by color Doppler. Results The levels of serum 14,15-DHET and 6-keto-PGF1α in serum of group B and group C were significantly lower than that of group A (P <0.01) and TXB2 (P <0.01) 6-keto-PGF1α ratio and TXB2 / 14,15-DHET ratio increased (P <0.01); (3) HbA1c, triglyceride and total cholesterol, urinary albumin excretion (UAE) increased (P <0.01). (4) EDV and NEDV decreased (P <0.01). (5) The 14,15-DHET content was negatively correlated with the duration of DM, the ratio of HbA1c, UAE, TXB2, TXB2 / 6-keto-PGF1α and TXB2 / 14,15-DHET, and positively correlated with EDV and NEDV. Conclusion The decrease of 14,15-DHET, a product of endothelium-dependent vasodilator in elderly DM and elderly DN patients, occurs in the early phase of DM. The same as PGI2, 14,15-DHET content changes can be used as DM, DN-related vascular EDV and NEDV function of one of the important indicators.