厄贝沙坦在健康志愿者体内的药代动力学-药效学结合模型

目的研究厄贝沙坦在健康志愿者体内的药代动力学-药效学结合模型,探讨其临床药效学特征。方法18例健康志愿者厄贝沙坦片口服给药,测定血药浓度,同时测量收缩压(SBP)、舒张压(DBP)及心率(HR)等药效指标。计算厄贝沙坦的药动学参数,并根据sheiner效应室模型理论,计算药效学参数。结果厄贝沙坦的血药浓度时间曲线呈二室模型;厄贝沙坦抑制SBP和DBP的效应滞后于血药浓度,药效与血药浓度之间存在逆时针滞后环,药效和效应室浓度的关系符合SigmoidEmax模型。厄贝沙坦抑制SBP和DBP的药效学参数Emax分别为(14.8±1.5)和(9.8±2.1)mmHg,EC50分别为(0.29±0.11)和(0.18±0.07)mg·L-1,Keo分别为(0.62±0.09)和(0.68±0.07)h-1。结论建立了厄贝沙坦在健康者体内的药代动力学-药效学结合模型,有利于临床合理用药。     

Altered L-arginine/nitric oxide synthase/nitric oxide pathway in the vascular adventitia of rats with sepsis

1. In recent studies, the vascular adventitia has been established as an important source of inducible nitric oxide synthase (iNOS) and subsequent nitric oxide (NO) production, even more powerful than the media in response to certain inflammatory factors, such as lipopolysaccharide (LPS). The adventitia has an independent L-arginine (L-Arg)/NOS/NO pathway and is involved in the regulation of vascular function. In the present study, we explored the changes in and the pathophysiological significance of the L-Arg/NOS/NO pathway in the adventitia of rats with sepsis. 2. Sepsis was induced by caecal ligation and puncture in order to observe changes in L-Arg transport, NOS gene expression and activity and NO generation in the vascular adventitia to determine the mechanism of activation of the L-Arg/NOS/NO pathway. 3. Severe sepsis resulted in severe disturbance of haemodynamic features, with decreased mean arterial blood pressure, brachycardia and inhibited cardiac function (decreased left ventricular +/-dP/dt(max)). Left ventricular end-diastolic pressure was elevated threefold (P < 0.01) under anaesthesia. Rats with sepsis showed severe glucopenia and lacticaemia. Plasma levels of the inflammatory factors macrophage chemoattractant protein-1 and interleukin-8 were increased five- and 29-fold, respectively (P < 0.01). 4. In the adventitia of the thoracic and abdominal aortas, the L-Arg/NO pathway was similarly characterized: the uptake of [(3)H]-L-Arg was Na(+) independent, with the peak occurring at approximately 40 min incubation. Total NOS activity was largely calcium independent (> 90%). The V(max) of L-Arg transport in the sepsis group was increased by 83.5% (P < 0.01), but the K(m) value was not significantly different compared with controls. 5. The mRNA levels of cationic amino acid transporter (CAT)-1 and CAT-2B in the sepsis group were increased by 86 and 62%, respectively (both P < 0.01). Inducible NOS activity was increased 2.8-fold compared with controls (P < 0.01) and iNOS mRNA levels were elevated approximately sixfold (P < 0.01). The NO levels in the plasma and incubation media (incubation for 40 min) in the sepsis group were increased by 144 and 273%, respectively (both P < 0.01). 6. The Arg/NOS/NO pathway was activated in the vascular adventitia of rats with sepsis shock. The L-Arg/NOS/NO pathway in the aortic adventitia may play an important role in the pathogenesis of sepsis and septic shock.     

Inability of rat alveolar macrophages to recycle l-citrulline to l-arginine despite induction of argininosuccinate synthetase mRNA and protein, and inhibition of nitric oxide synthesis by exogenous l-citrulline

In the present study it was tested whether rat alveolar macrophages (AMΦ) convert l-citrulline to l-arginine to maintain nitric oxide (NO) synthesis under conditions of limited availability of l-arginine. Rat AMΦ (0.5×10⁶ cells/well, cultured for 20 h in the absence or presence of 1 μg/ml lipopolysaccharides, LPS), were incubated for 6 h in amino acid-free Krebs solution and nitrite accumulation was determined as a measure of NO synthesis. After culture in the absence of LPS, nitrite in the incubation media was at the detection limit, independent of the addition of l-arginine or l-citrulline. AMΦ, cultured in the presence of LPS, produced about 4 nmol per 10⁶ cells and 6 h nitrite, and l-arginine enhanced nitrite accumulation in a concentration-dependent manner, maximally about threefold (EC₅₀: 55 μM). In LPS-treated AMΦ l-citrulline (up to 10 mM) failed to enhance nitrite accumulation, but rather inhibited it by about 50% in the presence of 100 μM l-arginine, i.e. when NO synthesis was enhanced. l-Arginine in the culture medium was ³H-labelled and its metabolism analysed by HPLC. In medium of AMΦ exposed to LPS [³H]-l-arginine was reduced by about 60% after a 20-h culture period and this was almost balanced by an almost equal increase in [³H]-l-citrulline and [³H]-l-ornithine, i.e. l-arginine was markedly consumed. When [¹⁴C]-l-citrulline was added to the culture medium of AMΦ, no significant formation of [¹⁴C]-l-arginine could be detected. On the other hand, argininosuccinate synthetase mRNA (by RT-PCR) and protein (by Western blot) was marginally detectable in control AMΦ, but clearly induced after exposure to LPS. Finally, l-citrulline was shown to inhibit l-arginine uptake in a concentration dependent manner, by about 50% at 10 mM. In conclusion, although the expression of argininosuccinate synthetase in rat AMΦ can be induced by LPS, AMΦ appear not to be able to recycle significant amounts of l-citrulline to l-arginine to maintain sustained NO synthesis. On the contrary, at high concentrations l-citrulline can reduce NO synthesis, and this effect appears to be caused by inhibitory effects on l-arginine uptake. Received: 21 April 1998 / Accepted: 2 October 1998     

普伐他汀对人内皮祖细胞一氧化氮合成的影响

目的观察普伐他汀对人内皮祖细胞（EPCs）一氧化氮（NO）合成的影响。方法密度梯度离心法获取外周血单个核细胞,培养7d后,收集贴壁细胞并分别加入普伐他汀,10μmol/L及100μmol/L干预48h,免疫组化、荧光显微镜和流式细胞仪鉴定EPC,用RT-PCR方法测定对细胞内皮型一氧化氮合酶（eNOS）mRNA表达的影响,并用硝酸还原酶法测定培养液中一氧化氮（NO）的水平。结果普伐他汀组的人内皮祖细胞eNOS mRNA的表达、NO的合成明显增加。结论普伐他汀可增加人内皮祖细胞eNOS mRNA的表达和NO的合成     

一氧化氮对成纤维细胞增殖及胶原合成的影响

在参与肝纤维化形成的细胞中，成纤维细胞能大量合成和分泌胶原蛋白。其质和量决定了组织器官的纤维化过程。我们研究发现，一氧化氮(nitric oxide，NO)具有抗肝纤维化作用。本文在此基础上，观察NO对体外培养的成纤维细胞增殖及胶原合成的影响，进一步阐明NO的抗肝纤维化作用。     

戊四唑癫痫大鼠脑组织一氧化氮含量和一氧化氮合酶活性变化

探讨一氧化氮在戊四唑癫病发机制中的作用。方法每天注射戊四唑建立在鼠癫痫模型,测定癫病发作后大鼠大脑皮质,海马一氧化氮和一氧化氮合酶活性变化,结果癫痫发作后海马ＮＯ含量和ＮＯＳ活性显著升高,结 戊四唑诱导的癫痫中具有致痫性。     

Effects of nitric oxide synthase inhibition with or without cyclooxygenase-2 inhibition on resting haemodynamics and responses to exendin-4

BACKGROUND AND PURPOSE: Interactions between the NO system and the cyclooxygenase systems may be important in cardiovascular regulation. Here we measured the effects of acute cyclooxygenase-2 inhibition (with parecoxib), alone and in combination with NOS inhibition (with NG-nitro-L-arginine methyl ester (L-NAME)), on resting cardiovascular variables and on responses to the glucagon-like peptide 1 agonist, exendin-4, which causes regionally-selective vasoconstriction and vasodilatation. EXPERIMENTAL APPROACH: Rats were instrumented with flow probes and intravascular catheters to measure regional haemodynamics in the conscious, freely moving state. L-NAME was administered as a primed infusion 180 min after administration of parecoxib or vehicle, and exendin-4 was given 60 min after the onset of L-NAME infusion. KEY RESULTS: Parecoxib had no effect on resting cardiovascular variables or on responses to L-NAME. Exendin-4 caused a pressor response accompanied by tachycardia, mesenteric vasoconstriction and hindquarters vasodilatation. Parecoxib did not affect haemodynamic responses to exendin-4, but L-NAME inhibited its hindquarters vasodilator and tachycardic effects. When combined, L-NAME and parecoxib almost abolished the hindquarters vasodilatation while enhancing the pressor response. CONCLUSIONS AND IMPLICATIONS: Cyclooxygenase-2-derived products do not affect basal haemodynamic status in conscious normotensive rats, or influence the NO system acutely. The inhibitory effects of L-NAME on the hindquarters vasodilator and tachycardic effects of exendin-4 are consistent with a previous study that showed those events to be beta-adrenoceptor mediated. The additional effect of parecoxib on responses to exendin-4 in the presence of L-NAME, is consistent with other evidence for enhanced involvement of vasodilator prostanoids when NO production is reduced.     

一氧化氮合酶抑制剂的研究进展

一氧化氮（ｎｉｔｒｉｃｏｘｉｄｅ,ＮＯ）是一种能调节细胞多种功能的信息分子,它参与心血管、外周和中枢神经以及免疫等系统生理过程和生物信号的调节。体内组织中的ＮＯ由ＮＯ合酶（Ｎｉｔｒｉｃｏｘｉｄｅｓｙｎｔｈａｓｅ,ＮＯＳ）催化左旋精氨酸而合成,合成后的ＮＯ迅速跨膜扩散释放。各种调节ＮＯ释放的因素均作用于ＮＯＳ催化的化学反应过程,而体内影响该反应的ＮＯＳ在各组织的表达不同。特异性ＮＯＳ抑制剂通过调控ＮＯ的合成,对ＮＯＳ表达相关的各种疾病的预防和治疗具有重要的临床意义。本文对近年来ＮＯＳ抑制剂的研究进展作一概述。     

Involvement of nitric oxide in the inhibition of angiogenesis by interleukin-2

Interleukin-2 (IL-2), an immunoregulatory cytokine possessing antitumour activity, is an inducer of nitric oxide (NO) synthesis in mice and man. In this study, the possibility that IL-2 possesses antiangiogenic properties that account for its antitumour effects in vivo was examined. IL-2 caused a dose-dependent inhibition of angiogenesis in the chick embryo chorioallantoic membrane (CAM). This inhibition was completely reversed by the NO synthase inhibitor N^G-nitro-L-arginine methylester (L-NAME). Furthermore, IL-2 was capable of stimulating NO synthase activity in the CAM in vitro and this effect was suppressed by L-NAME. Addition of IL-2 to human umbilical vein endothelial cells (HUVECs) in culture, had no effect on their growth characteristics. These results suggest that IL-2 may be an important antiangiogenic molecule causing its effect via nitric oxide synthesis. The antiangiogenic activity of IL-2 may be, at least in part, responsible for its antitumour properties.     

Effects of dopamine and nitric oxide on arterial pressure and renal function in volume expansion

1. The aim of the present study was to investigate the role of dopamine (DA) in the hypotensive and renal effects of L-arginine during extracellular fluid volume expansion (10% bodyweight). 2. Animals were randomized to non-expanded and expanded groups. Both groups received different treatments: L-arginine (250 mg/kg, i.v.), N(G)-nitro-L-arginine methyl ester (L-NAME; 1 mg/kg, i.v.), haloperidol (3 mg/kg, i.p.) and L-arginine + haloperidol (n = 8). Mean arterial pressure (MAP), diuresis, natriuresis, kaliuresis, glomerular filtration rate, renal plasma flow (RPF) and nitrite and nitrate (NO(x)) excretion were determined. 3. The increase in MAP induced by L-NAME was greater in expanded than in non-expanded rats (42 +/- 3 vs 32 +/- 3 mmHg, respectively; P < 0.01). Administration of haloperidol did not modify the L-arginine hypotensive effect. 4. Blockade of nitric oxide synthase diminished urine flow in non-expanded (4.15 +/- 0.56 vs 0.55 +/- 0.11 microL/min per 100 g; P < 0.01) and expanded animals (24.42 +/- 3.67 vs 17.85 +/- 2.16 microL/min per 100 g; P < 0.01). Diuresis induced by L-arginine was reduced by DA blockade in both non-expanded (17.15 +/- 2.11 vs 6.82 +/- 0.61 microL/min per 100 g; P < 0.01) and expanded animals (44.26 +/- 8.45 vs 25.43 +/- 5.12 microL/min per 100 g; P < 0.01). 5. Sodium excretion decreased with L-NAME treatment in non-expanded (0.22 +/- 0.03 vs 0.06 +/- 0.01 microEq/min per 100 g; P < 0.01) and expanded animals (3.72 +/- 0.70 vs 1.89 +/- 0.23 microEq/min per 100 g; P < 0.01). Natriuresis induced by L-arginine was diminished by haloperidol both in non-expanded (0.94 +/- 0.13 vs 0.43 +/- 0.04 microEq/min per 100 g; P < 0.01) and expanded rats (12.77 +/- 0.05 vs 3.53 +/- 0.75 microEq/min per 100 g; P < 0.01). Changes in kaliuresis changes seen following treatment with L-arginine, L-NAME and L-arginine + haloperidol followed a pattern similar to that observed for sodium excretion in both groups of rats. 6. L-arginine enhanced RPF in non-expanded animals (11.96 +/- 0.81 vs 14.52 +/- 1.05 mL/min per 100 g; P < 0.01). Glomerular filtration rate was increased by extracellular volume expansion (3.08 +/- 0.28 vs 5.42 +/- 0.46 mL/min per 100 g; P < 0.01). 7. The increase in NOx induced by acute volume expansion (0.18 +/- 0.03 vs 0.52 +/- 0.08 nmol/min per 100 g; P < 0.01) was diminished following the administration of haloperidol (0.52 +/- 0.08 vs 0.26 +/- 0.06 nmol/min per 100 g; P < 0.01). 8. Although DA does not participate in the actions of nitric oxide on vascular tone, both systems would play an important role in renal function adaptation during extracellular fluid volume expansion.     

Effect of multidose cilostazol on pharmacokinetic and lipid profile of atorvastatin in male Wistar rats

Objectives Atorvastatin (ATV) and cilostazol (CLZ) are often co‐prescribed to treat conditions such as peripheral arterial disease. In the present study, the drug–drug interaction potential of multi‐dose CLZ on both pharmacokinetics and the lipid‐lowering ability of single‐dose ATV is demonstrated. Method The pharmacokinetic parameters of ATV were determined in Wistar rats after per‐oral pre‐treatment with CLZ for 7 days in order to assess the interaction potential between ATV and CLZ. In‐vitro metabolic inhibition and everted gut sac studies were conducted to elucidate the mechanism of this interaction. Biochemistry analyser was used to estimate lipid profiles in Wistar rats. A validated LC‐MS/MS method was employed to simultaneously quantify both ATV and CLZ in rat plasma matrix. Key findings A statistically significant increase in systemic exposure to ATV after a single dose was observed in CLZ pre‐treated rats. In‐vitro metabolism studies using rat liver microsome (RLM) demonstrated statistically significant inhibition of ATV metabolism when co‐incubated with CLZ. No change in apparent permeability of ATV was observed in the presence of CLZ. The blood lipid profile study after ATV administration indicated a statistically significant decrease in total cholesterol, triglycerides and LDL‐cholesterol. Conclusions Multi‐dose administration of CLZ influences the pharmacokinetics and lipid‐lowering properties of ATV. Collectively, an apparent interaction between selected drugs was evident.     

Cardiovascular effects of chronic nitric oxide synthase inhibition in genetically hypertensive rats

1. The possible role of an endothelial defect in the hypertension of the New Zealand genetically hypertensive (GH) rat strain was assessed by examining cardiovascular responses to the nitric oxide synthase (NOS) inhibitor N omega-nitro-L-arginine methyl ester (L-NAME) and the endothelium-dependent depressor agent acetylcholine (ACh). The vascular sensitivity of the hindquarter to nitric oxide (NO) was examined using the NO donor sodium nitroprusside (SNP). 2. NG-Nitro-L-arginine methyl ester (10 mg/kg per day in drinking water) was given to GH and normotensive (N) rats from age 7-9 weeks, with GH and N untreated control groups. Systolic blood pressure (tail-cuff) was monitored weekly from age 5-9 weeks. At age 9 weeks, pressure responses to various vasoactive agents were measured in vivo and in the rat isolated hindquarter. Left ventricular (LV) mass was measured at the time of death. 3. NG-Nitro-L-arginine methyl ester induced a greater hypertensive effect in GH (P < 0.001) compared with N (P < 0.05) rats and caused a significant increase in hindquarter perfusion pressure in GH rats only (P < 0.01). 4. Genetically hypertensive rats had LV hypertrophy that was exacerbated by L-NAME (P < 0.01). Left ventricular hypertrophy was not induced by L-NAME in N rats. 5. The normalized response to ACh did not differ between GH and N control rats and was unaffected by L-NAME treatment in vivo and in vitro except at the highest ACh dose (3 micrograms/kg) in GH hindquarters (P < 0.01). The response to SNP was similar in GH and N hindquarters and enhanced by L-NAME in GH (0.1 microgram; P < 0.05) and N rats (0.01 microgram, P < 0.01; 0.01 microgram, P < 0.001). 6. These results suggest that the L-arginine/NO system is not deficient in GH rats and that endothelial function in the GH hindquarter is preserved. They confirm that NO is involved in mediating blood pressure in GH and N rats and raise the possibility that a non-NO-mediated mechanism may underlie ACh-induced vasodilation in GH and N.     

Effects of an endogenous nitric oxide synthase inhibitor on phorbol myristate acetate-induced acute lung injury in rats

1. In the present study, we determined whether the endogenous nitric oxide (NO) synthase (NOS) inhibitor Nomega-nitro-l-arginine methyl ester (l-NAME) could ameliorate the acute lung injury (ALI) induced by phorbol myristate acetate (PMA) in rat isolated lung. 2. Typical ALI was induced successfully by PMA during 60 min of observation. At 2 micro g/kg, PMA elicited a significant increase in microvascular permeability (measured using the capillary filtration coefficient Kfc), lung weight gain, lung weight/bodyweight ratio, pulmonary arterial pressure (PAP) and protein concentration of bronchoalveolar lavage fluid. 3. Pretreatment with the NOS inhibitor l-NAME (5 mmol/L) significantly attenuated ALI. None of the parameters reflective of lung injury showed significant increase, except for PAP (P < 0.001). The addition of l-arginine (4 mmol/L) blocked the protective effective of l-NAME. Pretreatment with l-arginine exacerbated PMA-induced lung injury. 4. These data suggest that l-NAME significantly ameliorates ALI induced by PMA in rats, indicating that endogenous NO plays a key role in the development of lung oedema in PMA-induced lung injury.     

一氧化氮对大鼠实验性肝纤维化的影响

目的　研究一氧化氮 (NO)在肝纤维化发病中的作用。方法　建立大鼠肝纤维化模型 ,给予NO前体———L 精氨酸 (L Arg)及一氧化氮合酶 (NOS)抑制剂———硝基 L 精氨酸 (L NNA) ,应用病理组织学检查、放免法及生化学方法 ,观察其对肝纤维化程度、透明质酸 (HA)含量、谷 草转氨酶 (AST)及谷 丙转氨酶 (ALT)活性的影响 ,同时测定NO、一氧化氮合酶 (NOS)水平变化。结果　NO能明显降低肝纤维化程度、HA含量、AST及ALT活性。结论　NO对大鼠具有保护肝细胞和抗肝纤维化作用     

骨关节炎患者血清和关节液一氧化氮及其合成酶变化的意义

目的探讨骨关节炎(OA)患者血清及关节液中一氧化氮(NO)和诱生型一氧化氮合成酶(iNOS)与病情程度及活动性的关系.方法对30例轻度(n=7)、中度(n=12)、重度(n=11)骨关节炎患者及24例健康对照者血清及关节液中NO、iNOS、ESR、CRP的含量进行测定.结果中、重度骨关节炎组血清中NO、iNOS水平比健康组升高(P＜0.01);三组骨关节炎关节液中NO、iNOS水平均比对照组明显升高(P＜0.001);重度骨关节炎组血清中NO、iNOS水平与关节液中NO、iNOS水平呈正相关(r=0.589,P＜0.01);重度骨关节炎组关节液中NO、iNOS水平与ESR、CRP呈正相关(r=0.428,p＜0.05).结论iNOS及其产生的NO参与了OA的病变过程,是OA病程发展的重要机制.     

一氧化氮在阿霉素心脏毒性中的双重作用

蒽环类抗生素阿霉素（Doxombicin,DOX）是一种高效的抗肿瘤药物,主要用于治疗血液学疾病以及各种实体瘤。但因其引发多重生物化学通道的细胞损伤,进而导致严重的剂量依赖性心脏毒性作用,使其临床应用及治疗指数受到限制与影响。NO是与心脏病理生理学相关的重要生物信使分子,其在阿霉素心脏毒性中的重要作用受到了普遍的关注。本文通过查阅近年来的国内外有关文献,对于此焦点问题进行了分析总结。     

一氧化氮在缺血性脑损伤中作用的实验研究进展

一氧化氮 (NO)在缺血性脑损伤中具有双重作用 ,既表现为神经保护作用 ,又有神经毒性作用。在脑缺血过程中 ,源于内皮型一氧化氮合酶 (eNOS)产生的NO有神经保护作用 ,源于神经元型一氧化氮合酶 (nNOS)和诱导型一氧化氮合酶 (iNOS)过度表达所形成的NO有神经毒性作用。利用NO的双重作用 ,找到防治脑缺血的药物及给药时间和剂量等一直是研究的热点。     

高压氧对脑梗死后血清一氧化氮和一氧化氮合酶含量的影响

目的 研究高压氧对脑梗死后血清一氧化氮、一氧化氮合酶含量的影响。方法 将脑梗死患者分为高压氧治疗组和非高压氧治疗组,观察不同病期血清一氧化氮、一氧化氮合酶含量的变化,并与正常对照组进行比较。结果 高压氧治疗组一氧化氮含量较非高压氧治疗组上升快,在治疗后15天恢复正常,但在一疗程高压氧治疗结束后,却又有所下降;一氧化氮合酶含量在治疗后均有上升,未能恢复到正常水平,两组之间无差异。结论 高压氧通过提高NO的含量,减轻缺血区脑组织的损伤,改善脑血循环;高压氧对NOS有一定影响,但作用不大;应适当延长高压氧疗程,尽可能缓解因NOS含量下降所造成的NO释放量不足。     

Inhaled and systemic corticosteroid response in severe asthma assessed by alveolar nitric oxide: a randomized crossover pilot study of add-on therapy

AIMS

Alveolar nitric oxide (CA_NO) is a potential biomarker of small airway inflammation. We investigated effects on CA_NO of the addition of coarse and fine particle inhaled corticosteroids to standard therapy in severe asthma.

METHODS

Severe asthmatics taking ≥1600 µg day⁻¹ budesonide or equivalent performed a randomized open-label crossover study. Subjects with FEV₁ < 80%, gas trapping and CA_NO≥2 ppb entered a 6 week dose-ramp run-in of fluticasone/salmeterol(FPSM) 250/50 µg twice daily for 3 weeks, then 500/50 µg twice daily for 3 weeks. Patients then received additional HFA-beclomethasone diproprionate (BDP) 200 µg twice daily or FP 250 µg twice daily for 3 weeks in a crossover. Participants then received prednisolone(PRED) 25 mg day⁻¹ for 1 week. Nitric oxide, lung function, mannitol challenge, systemic inflammatory markers and urinary cortisol were measured.

RESULTS

Fifteen completed per protocol: mean (SD) age 51 (12) years, FEV₁ 58 (13)% predicted, residual volume 193 (100)% predicted and mannitol_PD10 177 (2.8) µg. There was no significant difference between FPSM and add-on therapy for CA_NO. FPSM/BDP and FPSM/PRED suppressed broncial flux (Jaw_NO) and FE_NO compared with FPSM alone, but there was no significant difference between FPSM/BDP and FPSM/FP. ECP, e-selectin and ICAM-1 were suppressed by FPSM/PRED compared with FPSM and FPSM/FP but not FPSM/BDP. Plasma cortisol was significantly suppressed by FPSM/PRED.

CONCLUSION

In severe asthma, CA_NO is insensitive to changes in dose and delivery of inhaled corticosteroids and is not suppressed by systemic corticosteroids. Additional inhaled HFA-BDP reduced FE_NO and Jaw_NO without adrenal suppression. There was a trend to reduction in FE_NO and Jaw_NO with additional FP but this did not reach statistical significance. PRED reduced FE_NO and Jaw_NO with suppression of systemic inflammatory markers and urinary cortisol.     

老年糖尿病合并高血压患者血清内脂素与一氧化氮、一氧化氮合酶的关系

目的：研究老年糖尿病（DM）合并高血压（HT）患者血清内脂素（visfatin）水平的变化及与一氧化氮（NO）、一氧化氮合酶（NOS）的关系.方法：选择合并HT和血压正常老年DM患者各60例、正常老年人30例,测定其血清visfatin、NO、NOS水平.结果：与血压正常组比较合并HT老年DM患者血清visfatin明显升高（P＜0.01）,血清NO、NOS水平明显降低.（P＜0.01）.合并HT老年DM患者血清visfatin与平均动脉压（MAP）呈明显正相关（P＜0.01）,血清NO、NOS水平与MAP呈明显负相关（r=-0.587,r=-0.641,均P＜0.01）.血清visfatin与NO、NOS水平呈明显负相关（r=-0.628,r=-0.663,均P＜ 0.01）.结论：老年DM合并HT患者血清visfatin明显升高,血清NO、NOS水平明显降低,血清visfatin与NO、NOS相互作用在老年DM合并HT的发生发展中发挥重要作用.