通心络胶囊联合津力达颗粒对2型糖尿病合并冠心病患者血管内皮功能和miR-155含量的影响

目的在常规治疗的基础上,探究通心络胶囊联合津力达颗粒治疗2型糖尿病(T2DM)合并冠心病(CAD)的疗效及对血管内皮功能和miR-155含量的影响。方法将122例T2DM合并CAD患者均衡随机分为常规治疗组、常规联合通心络组、常规联合津力达组和常规联合通心络与津力达组。检测各组血压、血糖、血脂和肝与肾功能。用Elisa法检测血浆内皮素-1(ET-1)、血管内皮生长因子(VEGF)和血管细胞黏附蛋白-1(VCAM-1);用q-PCR法检测血浆微小RNA-155-5p(miR-155-5p)和miR-155-3p含量。结果常规联合通心络和津力达组空腹血糖、餐后2 h血糖、低密度脂蛋白(LDL-C)、极低密度脂蛋白(VLDL-C)、总胆固醇(TG)、三酰甘油(TC)、舒张压(SBP)、收缩压(DBP)、ET-1、VEGF、VCAM-1、miR-155-5p和miR-155-3p均显著低于其他各组,而HDL-C明显高于其他各组(P<0.05);血肌酐(SCr)、尿素氮(BUN)、尿酸、谷丙转氨酶(ALT)和谷草转氨酶(AST)无明显变化;miR-155-5p和miR-155-3p与ET-1、VEGF呈明显正相关(P<0.05),与VCAM-1无相关性。结论常规治疗联用通心络胶囊和津力达颗粒对T2DM伴CAD患者具有良好的治疗作用,且与内皮功能有关,其外周血miR-155可作为治疗的监测指标并具有潜在调控内皮功能的作用。

Effect of conventional therapy combined with Tongxinluo Capsules and Jinlida Granules on vascular endothelial function and miR-155 content in patients with type 2 diabetes mellitus complicated with coronary heart disease

Objective To investigate the effects of conventional therapy combined with Tongxinluo Capsules(Tongxinluo)and Jinlida Granules(Jinlida)on coronary heart disease complicated with type 2 diabetes and its effect on vascular endothelial function and miR-155 content.Methods A total of 122 patients with type 2 diabetes mellitus complicated with coronary heart disease were randomly divided into 4 groups:conventional treatment group,conventional treatment combined with Tongxinluo group,conventional treatment combined with Jinlida group and conventional treatment combined with Tongxinluo and Jinlida group.Blood pressure,blood glucose,blood lipids,as well as liver and kidney function,were evaluated.Plasma endothelin-1(ET-1),vascular endothelial growth factor(VEGF),and vascular cell adhesion protein 1(VCAM-1)were detected by Elisa.miR-155-5p and miR-155-3p were detected by q-PCR.Results Fasting blood glucose,2 h postprandial blood glucose,low-density lipoprotein(LDL-C),very low density lipoprotein(VLDL-C),total cholesterol(TG),triglyceride(TC),diastolic blood pressure(SBP),systolic blood pressure(DBP),ET-1,VEGF and VCAM-1,miR-155-5p and miR-155-3p levels in conventional treatment combined with Tongxinluo and Jinlida group were significantly lower than in the other groups,HDL-C was significantly higher than other treatment groups(P<0.05);Scr,BUN and uric acid content,blood ALT and AST did not change obviously;Plasma miR-155-5p and miR-155-3p were positively correlated with ET-1 and VEGF levels(P<0.05),but no significant correlation with VCAM-1.Conclusion conventional therapy combined with Tongxinluo and Jinlida has a good therapeutic effect on coronary heart disease complicated with type 2 diabetes,and its mechanism is related to endothelial function.The patients′peripheral blood miR-155 can be used as a monitoring index and has potential to regulate endothelial function.