长期二甲双胍干预对新诊断2型糖尿病患者心肌肥厚程度及心血管事件的影响  

Effects of long-term metformin intervention on degree of cardiac hypertrophy and cardiovascular events in newly diagnosed type 2 diabetic patients

作　　者：呼双琴[1] 白小岗[1] 李社丽 

机构地区：[1]延安大学附属医院内分泌科,陕西延安716000

出　　处：《临床和实验医学杂志》2016年第18期1806-1810,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的探析长期二甲双胍干预对新诊断2型糖尿病患者心肌肥厚程度及心血管事件的影响。方法选取2012年1月至2014年1月期间新确诊2型糖尿病患者116例作为研究对象,分为观察组与对照组,各58例。两组首先予以胰岛素泵治疗,待血糖完全达标后对照组继续原方案,观察组应用二甲双胍,两组药物干预时间均为2年。比较两组随访半年、1年及2年的血糖达标率、随访前后胰岛素抵抗(HOMA-IR)、体质指数(BMI)、心肌肥厚程度[心肌重量(LVM)、左室质量指数(LVMI)]、血浆一氧化氮(NO)、左室射血分数(LVEF)、血脂指标三酰甘油(TG)、总胆固醇(TC);比较两组随访期间心血管事件发生率并观察药物安全性。结果两组随访半年、1年时血糖达标率的差异均无统计学意义(P>0.05);随访结束时观察组血糖达标率为85.7%,高于对照组69.1%,差异有统计学意义(P<0.05)。两组随访前HOMA-IR、BMI、LVM、LVMI、NO、LVEF、TG及TC的差异均无统计学意义(P>0.05);随访结束时观察组HOMA-IR、BMI、LVM、LVMI、NO、LVEF、TG与TC均低于随访前及对照组随访结束时,差异有统计学意义(P<0.05)。观察组随访期间心血管事件发生率为3.8%,低于对照组14.5%,差异有统计学意义(P<0.05)。观察组轻度低血糖发生率为8.9%,对照组为12.7%,差异无统计学意义(P>0.05)。结论二甲双胍长期干预可有效维持血糖稳定、改善胰岛素抵抗与血脂代谢,减轻心肌肥厚情况并抗动脉粥样硬化,体重控制效果更佳,且具有明显心血管保护作用,可减少心血管事件,为安全治疗方案,值得推广。Objective To explore the effect of long - term metformin intervention on degree of cardiac hypertrophy and cardiovascular e-vents in newly diagnosed type 2 diabetic patients. Methods 116 newly diagnosed type 2 diabetic patients who were admitted from our hospital between January 2012 and January 2014 were selected as the study objects and randomized divided into the observation group and control group, 58 cases in each group. Both of the two groups were firstly treated with insulin pump. When blood glucose reached the standard completely, the control group was treated with the initial regimen while the observation group was treated with metformin. Both of the two groups received 2 years of drug intervention. The control rate of blood glucose, Homeostasis model assessment for insulin resistance （HOMA - IR） , BMI, degree of cardiac hypertrophy （ LVM, LVMI） , plasma NO , LVEF and blood lipid levels （TG, TC） in half - year, 1 - year and 2 - year follow - up were compared between the two groups. The incidence of cardiovascular events during follow - up was compared between the two groups and the drug safety was observed. Results Half year and lyear of follow - up later, there were no significant differences in control rate of blood glucose between the two groups（ P 〉 0. 05） ; At the end of follow - up, the control rate of blood glucose in the observation group（85. 7% ） was higher than that in the con-trol group （69.1%） （ P 〈0.05）. Before follow - up, there were no significant differences in HOMA - IR, BMI, LVM, LVMI, NO, LVEF, TG and TC between the two groups （ P 〉 0. 05）. At the end of follow - up, HOMA - IR, BMI, LVM, LVMI, NO, LVEF, TG and TC in the observation group were lower than those before follow - up and those in the control group at the end of follow - up （ P 〈 0. 05）. During the follow - up , the incidence of cardiovascular events in the observation group （3.8%） was lower than that in the control group （14. 5% ） （ P 〈 0 . 0 5 ） . T h

关 键 词：2型糖尿病 二甲双胍 心肌肥厚 心血管事件 

分 类 号：R587.1[医药卫生—内分泌] R542.2[医药卫生—内科学]