1 华中科技大学同济医学院附属武汉中心医院内分泌科，武汉 430014
|| 2016 年度武汉市临床医学科研项目基金(WX16C42)；湖北省卫生和计划生育委员会项目(WJ2017W183)。
目的：评价硫辛酸对2型糖尿病(type 2 diabetes mellitus，T2DM)并下肢周围动脉疾病(peripheral arterial disease，PAD)患者循环血中内皮微粒(endothelial microparticle，EMP)和氧化应激的影响。方法：连续收集2017年4至10月于华中科技大学同济医学院附属武汉中心医院住院的经药物治疗血糖不达标的T2DM并PAD患者48例，随机分为糖尿病综合管理治疗组(管理组)与硫辛酸联合糖尿病综合管理治疗组(联合组)，每组各24例。管理组仅给予糖尿病综合管理降糖治疗，联合组在糖尿病综合管理基础上联用硫辛酸治疗，2组均干预12周，治疗前后测定并比较患者血浆EMP水平、踝动脉-肱动脉血压比值(ankle-branchial index，ABI)、活性氧(reactive oxygen species，ROS)及丙二醛(methane dicarboxylic aldehyde，MDA)。结果：管理组治疗后EMP水平略有降低(P>0.05)， 联合组治疗后EMP水平显著降低(P<0.01)，且明显低于管理组(P<0.01)；联合组治疗后ABI指数略有增加(P>0.05)，且略高于管理组(P>0.05)。联合组治疗后ROS，MDA显著低于治疗前和管理组(P<0.05)。结论：在T2DM合并下肢PAD患者中，硫辛酸联合糖尿病综合管理可明显降低循环血中EMP和氧化应激水平，有助减轻糖尿病患者下肢PAD。
Effect of lipoic acid treatment on endothelial microparticles and oxidative stress in patients with diabetic peripheral artery disease in lower limbs
This work was supported by the Wuhan Clinical Medical Research Project Foundation in 2016 (WX16C42) and Hubei Provincial Health and Family Planning Commission Project (WJ2017W183), China.
Objective: To evaluate the effect of lipoic acid on endothelial microparticle (EMP) and oxidative stress in type 2 diabetes mellitus (T2DM) patients with peripheral artery disease (PAD) of the lower limbs. Methods: Forty-eight T2DM patients with PAD of the lower limbs were randomly divided into two groups: a joint group and a management group (24 cases for each). Patients of management group only received multi-healthcare therapy for 12 weeks. Patients of joint group were treated with both lipoic acid treatment and multi-healthcare therapy at the same time for 12 weeks. The levels of EMP, ankle-brachial index (ABI), reactive oxygen species (ROS) and methane dicarboxylic aldehyde (MDA) in venous blood were estimated before and after treatment by flow cytometry. Results: Compared to the management group, EMP value showed a significant reduction in joint group (P<0.01). The EMP value of joint group went down obviously as compared that before combined treatment (P<0.01). Patients treated with lipoic acid treatment and multi-healthcare therapy seemed have higher levels of ABI than the management group (P>0.05). The level of ROS and MDA in joint group was significantly lower than that in management group and treatment before (P<0.05). Conclusion: Lipoic acid combined with multihealthcare significantly decrease the level of EMP in T2DM patients with PAD of lower limbs. They are effective therapies for T2DM patients with PAD.
lipoic acid; endothelial microparticle; type 2 diabetes mellitus; peripheral arterial disease