论文部分内容阅读
目的研究单纯高甘油三酯血症患者血管内皮细胞功能、血胰岛素、胶原代谢的变化,以探讨血管内皮功能、胰岛素、胶原代谢的相关性以及非诺贝特的干预作用。方法随机抽取单纯高甘油三酯血症患者20例,每日早空腹口服微粒化非诺贝特200 mg。分别于治疗前、治疗4周、治疗8周采空腹肘静脉血,测定血脂、血管内皮细胞计数(VEC)、血浆内皮素(ET-1)、一氧化氮(NO)、血胰岛素(INS)、Ⅲ型前胶原(PC-Ⅲ)。同时选年龄、性别相匹配的健康人20例作为正常对照组(对照组),入选时仅采空腹肘静脉血一次,观察指标同治疗组。结果高甘油三酯血症患者经非诺贝特治疗4周与治疗前比较,血TG水平即明显下降(P<0.01),治疗8周与4周比较,血TG明显下降(P<0.01),HDL-C则明显升高(P<0.05)。治疗组患者血ET-1、CEC计数、INS和PC-Ⅲ浓度,治疗前均高于对照组(P<0.01)。高TG组经服用非诺贝特治疗4周,血PC-Ⅲ浓度、CEC计数较治疗前降低(P<0.05,P<0.01),治疗8周时,血ET-1、INS、PC-Ⅲ浓度、CEC计数较治疗前进一步下降(P<0.01),NO浓度明显升高(P<0.05)。INS与ET-1(r=0.36,P<0.01)、CEC(r=0.26,P<0.01)计数均呈正相关,PC-Ⅲ与ET-1(r=0.41,P<0.01)、CEC(r=0.32,P<0.01)计数均呈正相关,INS、PC-Ⅲ与NO(r=-0.20,P<0.01;r=-0.11,P<0.05)呈负相关,INS与PC-Ⅲ(r=0.56,P<0.01)亦呈正相关。结论单纯高甘油三酯患者存在血管内皮功能异常、高胰岛素血症及胶原代谢异常。非诺贝特在降低甘油三酯,改善脂代谢异常的同时,亦改善胰岛素抵抗,改善内皮功能,抑制胶原合成。
Objective To investigate the changes of vascular endothelial cell function, blood insulin and collagen metabolism in patients with hypertriglyceridemia, and to explore the correlation between vascular endothelial function, insulin and collagen metabolism and the effect of fenofibrate. Methods Twenty patients with hypertriglyceridemia were randomly enrolled in this study. 200 mg of micronized fenofibrate was administered daily to the fasting abdominal cavity. The levels of serum lipids, vascular endothelial cell counts (VEC), plasma endothelin-1 (ET-1), nitric oxide (NO) and insulin (INS) were measured before and 4 weeks after treatment. , Procollagen type Ⅲ (PC-Ⅲ). At the same time select 20 healthy people of the same age and gender as normal control group (control group), selected only fasting vena and umbilical blood once observation index with the treatment group. Results Compared with pre-treatment, the levels of TG in serum of hypertriglyceridemic patients were significantly decreased after 4 weeks of fenofibrate treatment (P <0.01) , HDL-C was significantly higher (P <0.05). The levels of ET-1, CEC, INS and PC-Ⅲ in the treatment group were higher than those in the control group before treatment (P <0.01). The levels of ET-1, INS, PC-Ⅲ in serum of high-TG group were lower than those before treatment (P <0.05, P <0.01) The concentration and CEC count decreased further (P <0.01) and NO concentration increased significantly (P <0.05). There was a positive correlation between INS and ET-1 (r = 0.36, P <0.01) and CEC (r = 0.26, P <0.01) = 0.32, P <0.01). There was a negative correlation between INS and PC-Ⅲ and NO (r = -0.20, P <0.01; 0.56, P <0.01) also showed a positive correlation. Conclusions Patients with simple hypertriglyceridemia have abnormal vascular endothelial function, hyperinsulinemia and abnormal collagen metabolism. Fenofibrate in reducing triglycerides, improve lipid metabolism abnormalities, but also improve insulin resistance, improve endothelial function, inhibit collagen synthesis.