摘要
目的观察胰高糖素样肽-1(GLP-1)激动剂利拉鲁肽联合替格瑞洛治疗2型糖尿病合并冠心病的疗效,及其对患者血清甲壳质酶蛋白40(YKL-40)及过氧化物酶体增殖物激活受体γ(PPARγ)的影响。方法选择2型糖尿病合并冠心病患者216例,随机均分为对照组和观察组。观察组给予利拉鲁肽注射液联合替格瑞洛,对照组给予盐酸二甲双胍片联合替格瑞洛,两组均治疗2个月。比较两组治疗效果、心功能指标、血管内皮相关因子、YKL-40、PPARγ水平以及治疗期间心血管不良事件发生率。结果与对照组比较,观察组冠心病治疗总有效率更高(P<0.05),糖尿病控制良好率差异无显著性(P>0.05)。治疗后观察组左心室舒张期末内径、左心室舒张期末室间隔厚度、左心室后壁厚度、内皮素-1、细胞间黏附分子-1、血管内皮钙黏蛋白、髓过氧化物酶及YKL-40均低于对照组(P<0.05),左心室射血分数、二尖瓣舒张早与晚期血流峰值速度比值、一氧化氮及PPARγ均高于对照组(P<0.05)。观察组与对照组发生主要心血管不良事件率差异无显著性(P>0.05)。结论GLP-1激动剂联合替格瑞洛治疗2型糖尿病合并冠心病取得了较好的疗效,可降低血管内皮细胞损伤,改善炎症反应及胰岛素抵抗。
Aim To observe the efficacy of glucagon-like peptide-1(GLP-1)agonist combined with tigrilol in the treatment of type 2 diabetes mellitus with coronary heart disease and its effect on serum chitinase protein 40(YKL-40)and peroxisome activated receptorγ(PPARγ)in patients.Methods A total of 216 patients with type 2 diabetes mellitus complicated with coronary heart disease were randomly divided into control group and observation group.The observation group was given Liraglutide injection combined with ticagrelor,and the control group was given metformin hydrochloride tablet combined with ticagrelor.Both groups were treated for 2 months.The treatment effect,cardiac function indexes,vascular endothelium-related factors,YKL-40,PPARγlevels and the incidence of cardiovascular adverse events were compared between the two groups.Results Compared with the control group,the total effective rate of coronary heart disease in the observation group was higher(P<0.05),and there was no significant difference in the control rate of diabetes(P>0.05).After treatment,the left ventricular end diastolic diameter,left ventricular septal thickness,left ventricular posterior wall thickness,endothelin-1,intercellular adhesion factor-1,vascular endothelial cell cadherin,myeloperoxidase and YKL-40 in the observation group were lower than those in the control group(P<0.05),while the left ventricular ejection fraction,E/A of early and late diastolic mitral valveγ.NO and PPAR were higher than those in the control group.There was no significant difference in the incidence of cardiovascular adverse events between the observation group and the control group(P>0.05).Conclusion GLP-1 agonist combined with tigrilol in the treatment of type 2 diabetes with coronary heart disease has achieved good results,which can reduce vascular endothelial cell injury,and effectively improve the inflammatory response and insulin resistance in patients.
作者
黄志龙
都渝
赵君
HUANG Zhilong;DU Yu;ZHAO Jun(Department of Pharmacy,Qinghai Cardiovascular and Cerebrovascular Disease Hospital,Xining,Qinghai 810000,China)
出处
《中南医学科学杂志》
CAS
2021年第5期559-563,共5页
Medical Science Journal of Central South China
基金
青海省科技厅科技计划项目(9632021Y0140)。
