·糖尿病与大血管病·

　　【摘要】 目的 观察糖尿病冠状动脉粥样硬化程度与外周血单个核细胞(PBMC)上糖基化终产物受体(RAGE)的相关性，及他汀类药物的影响。 方法 选择188例行冠脉造影的患者，采用RT-PCR和Western blot检测PBMC上RAGE的表达，根据糖代谢状态和他汀类药物使用情况进行分组后与冠状动脉的病变支数和Gensini积分做相关性分析。 结果 与常规组比较，他汀组PBMC上RAGE mRNA表达量(P=0.001)和RAGE蛋白水平(P=0.000)、冠状动脉病变支数(P=0.004)和Gensini积分(P=0.000)明显降低。在常规组中糖尿病患者PBMC上RAGE mRNA表达量(P=0.02)和RAGE蛋白的水平(P=0.000)高于非糖尿病患者。回归分析表明PBMC上RAGE mRNA表达量是冠状动脉多支病变和严重程度的独立危险因素。 结论 PBMC上RAGE的表达与糖尿病冠状动脉粥样硬化密切相关，而他汀类药物可能通过下调RAGE的表达而改善冠状动脉粥样硬化。

　　【关键词】 糖尿病;动脉粥样硬化;糖基化终产物受体;他汀

　　　【Abstract】Objective To investigate the relation of the mRNA and protein levels of the receptor for advanced glycation end products (RAGE) in peripheral blood mononuclear cells (PBMCs) with diabetic coronary atherosclerosis and to evaluate the protective effect of statins. Methods The 188 atherosclerosis patients with or without T2DM underwent coronary arteriography were divided into two groups: statin treated group (89 cases) and non-statin treated group (99 cases). The severity of coronary atherosclerosis was estimated by counting the number of diseased vessels and Gensini score using coronary angiography. The mRNA and protein levels of RAGE in PBMCs were measured by RT-PCR and Western blot. Results Compared with the non-statin treated group, there were significant decreases in the RAGE mRNA level (P=0.001), the RAGE protein level (P=0.000), the number of coronary artery diseased vessels (P=0.004), and Gensini score (P=0.000) in the statin treated group. The RAGE mRNA level (P=0.02) and RAGE protein level (P=0.000) of the diabetes patients were higher than those of the non-diabetes patients in the non-statin treated group. The regression analysis indicated that the RAGE mRNA level in PBMCs was an independent risk factor of the severity of coronary atherosclerosis. Conclusions The RAGE level in PBMC is closely related to the diabetic coronary atherosclerosis. The effect of statins on improving the severity of coronary atherosclerosis may be realized by reducing the RAGE expression.

　　【Key words】Diabetes mellitus; Atherosclerosis; Receptor for advanced glycation end products (RAGE); Statins