Protective effect of valsartan combined with alprostadil in the vascular endothelium of patients with T2DM and hypertension and the effect on oxidation substances
ZHAO Yueping1, SUN Zhe2, LIU Jing3, YUAN Feiyang1, SUN Mengmeng1, SU Hong1, and SONG Tao1
1.Department One of Internal Medicine, 2.Department of Clinical Laboratory, 3.Medical Department, Liaoning Provincial Corps Hospital of Chinese People’s Armed Police Force, Shenyang 11034, China
Abstract：Objective To observe the protective effect of valsartan combined with alprostadil on the function of vascular endothelium and the effect on the concentration of oxidants in patients with early type 2 diabetes mellitus (T2DM) complicated with hypertension.Methods Between May 2017 and September 2018, 100 patients with early type 2 diabetes mellitus (T2DM) complicated with hypertension but without microangiopathy were selected and randomly divided into the control group (n=50) and observation group (n=50). Both groups were treated with hypotensive drugs (valsartan), hypoglycemic drugs (metformin+acarbose tablets) and improved circulation (ginkgo biloba extract), but the observation group was additionally given alprostadil. After 60 days of continuous treatment, the levels of fasting blood glucose (FBG) and postprandial 2-hour blood glucose (2 h PBG), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), the concentration of vasodilators [nitric oxide (NO), endothelin-1 (ET-1), vascular endothelial growth factor (VEGF)] and its flow-mediated endothelium-dependent vasodilation of the brachial artery (FMD), nitroglycerin mediated endothelium-independent vasodilation (NMD), oxidation-related substances (superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), reactive oxygen species (ROS) activity, and the concentration of malondialdehyde (MDA) were observed. The clinical efficacy was evaluated and the adverse reactions during the treatment were recorded.Results After treatment, FBG and PBG in the two groups were significantly lower (P＜0.05), but there was no significant difference in BMI between the two groups (P＞0.05).There was no significant difference in FBG, PBG or BMI between the two groups after treatment (P＞0.05). After treatment, SBP, DBP, ET-1, VEGF, ROS and MDA in the two groups were lower, and the difference was statistically significant (P＜0.05). After treatment, SBP, DBP, ET-1, VEGF, ROS and MDA in the observation group were significantly lower than those in the control group (P＜0.05). After treatment, NO, FMD, NMD, SOD and GSH-Px in the two groups were higher. The difference was statistically significant (P＜0.05). After treatment, NO, FMD, NMD, SOD and GSH-Px in the observation group were significantly higher than in the control group (P＜0.05). There was no serious adverse reaction (AEs) in either group, but such mild gastrointestinal reaction as rash and dry cough occurred in both groups, and there was no significant difference in the incidence between the two groups.Conclusions On the basis of hypoglycemic and hypotensive treatment, alprostadil can improve vascular endothelial function, improve the imbalance between oxidation and antioxidation, and improve the clinical effect in patients with T2DM complicated with hypertension without microangiopathy in the early stage.
赵跃萍, 孙喆, 刘静, 袁菲阳, 孙萌萌, 苏宏, 宋涛. 前列地尔对早期2型糖尿病合并高血压患者血管内皮功能及氧化物质的影响[J]. 武警医学, 2019, 30(10): 829-833.
ZHAO Yueping, SUN Zhe, LIU Jing, YUAN Feiyang, SUN Mengmeng, SU Hong, and SONG Tao. Protective effect of valsartan combined with alprostadil in the vascular endothelium of patients with T2DM and hypertension and the effect on oxidation substances. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(10): 829-833.
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