西格列汀对糖尿病合并动脉粥样硬化患者的治疗作用  

Therapeutic effect of Sitagliptin Phosphate Tablets on the treatment of diabetic atherosclerosis and its advantages

作　　者：毛艳玲[1] 林毅辉[1] 彭雪峰[1] 何芳[1] 

机构地区：[1]福建医科大学附属泉州市第一医院内分泌代谢科,福建泉州362018

出　　处：《黑龙江医药科学》2014年第5期16-18,共3页Heilongjiang Medicine and Pharmacy

摘　　要：目的：观察西格列汀对糖尿病及合并动脉粥样硬化患者CRP水平及单核细胞趋化蛋白-1（MCP-1）及血管细胞黏附分子-1 （VCAM-1）mRNA表达的影响及优势,探讨西格列汀在糖尿病患者抗动脉粥样硬化的作用及机制.方法：选取2011-03～2013-06门诊就诊及住院的90例初次确诊2型糖尿病患者（经口服葡萄糖耐量试验及胰岛素、C肽激发试验）,年龄（50.77±12.54）岁,首次就诊内分泌科,未经降血糖、降脂、抗血小板等治疗,其中39例彩超提示颈动脉粥样硬化板块形成（硬斑或/和软斑）.分为单纯糖尿病组（51例）和已合并颈动脉粥样硬化组（39例）,90例患者经糖尿病宣教后,均给予糖尿病饮食及适当运动锻炼,同时给予西格列汀100mg qd降血糖治疗;测定治疗前及治疗6月后空腹胰岛素及CRP、糖基化血红蛋白,并采用逆转录多聚酶链反应（RT-PCR）方法检测静脉血中MCP-1、VCAM-1 mRNA表达水平的变化.结果：（1）两组治疗后,糖基化血红蛋白水平均显著降低（P＜0.01）,空腹血清胰岛素水平显著升高（P＜0.05）;（2）同期相比,糖尿病合并颈动脉粥样硬化组CRP水平显著高于于单纯糖尿病组（P＜0.05）;单纯糖尿病组治疗前后CRP水平无明显变化（P＞0.05）,糖尿病合并颈动脉粥样硬化组治疗3月后CRP水平显著降低（P＜0.01）;（3）同期相比,糖尿病合并颈动脉粥样硬化组MCP-1、VCAM-1mRNA表达水平显著高于于单纯糖尿病组（P＜0.05）;单纯糖尿病组治疗前后MCP-1、VCAM-1 mRNA表达水平无明显变化（P＞0.05）,糖尿病合并颈动脉粥样硬化组治疗3月后MCP-1、VCAM-1 mRNA表达水平水平显著降低（P＜0.01）.结论：CRP可导致动脉粥样硬化的发生;西格列汀具有降糖之外的直接抗动脉粥样硬化作用;西格列汀抗动脉粥样硬化作用部分是通过降低MCP-1、VCAM-1的表达实现的。Objective. To observe the influences of Sitagliptin on CRP level, MCP--1, and VCAM--1 mRNA expression of diabetes patients with atheroselerosis; and to discuss the function of Sitagliptin on anti-- atherosclerosis for diabetes patients and its mechanism. Methods： 90 cases of patients who were diagnosed as type 2 diabetes from March to June in 2011 were selected. All of them were given oral glucose tolerance test and insulin, C peptide stimulation test. Their ages ranged from 50 to 73 years old. They visited endocrinology department without treatment of hypoglycemic action, lipid lowering, anti platelet and so on. Among them, 39 cases formed Carotid atherosclerosis plate through color ultrasound （hard plate and soft plate）. They were divided into 2 groups, single diabetes group （51 cases） and diabetes with Carotid atherosclerosis group （39cases）. After diabetes propaganda and education, they exercised diabetic diet and proper sports, and were given 100mg qd Stagliptin hypoglycemic action. The values of insulin under empty stomach, CRP, glyeosylated hemoglobin before treatments and 6 months after treatments were measured. RT--PCR methods were adopted to test the changes of MCP--1,and VCAM--1 mRNA expression level in venous blood. Results： （1） After treatments, the GHb levels of both 2 groups obviously decrease （P 〈 0.01） and the insulin levels under empty stomach increase obviously （P 〈 0.05） ; （2） Compared in same period, the CRP level of diabetes with Carotid atherosclerosis group is obviously higher than single diabetes group （P 〈 0.05） ; there is not obviously in CRP level of single diabetes group before and after treatments （P 〉 0.05） and the CRP level of diabetes with Carotid atherosclerosis group decreases obviously 3 months after treatment （P 〈 0.01）. （3）During the same period, the expression levels of MCP--1,VCAM--1 mRNA in diabetes with Carotid atherosclerosis group are obviously higher than those in single diabetes group （P 〈 0.05） ; there i

关 键 词：罗格列酮 MCP-1 VCAM-1 动脉粥样硬化 

分 类 号：R587.1[医药卫生—内分泌]