西格列汀对初发2型糖尿病患者颈动脉内膜中层厚度及hs-CRP与IL-6的影响  

Effect of sitagliptin on carotid intima-media thickness and hs-CRP and IL-6 in the patients with newly diagnosed type 2 diabetes mellitus

作　　者：曾文平[1] 熊艳华[1] 黄敬垣[1] 沈世恩[1] 唐礼江[1] ZENG Wenping;XIONG Yanhua;HUANG Jingyuan;SHEN Shien;TANG Lijiang(Department of Cardiology,Zhejiang Hospital,Hangzhou 310013,China)

机构地区：[1]浙江医院心内科,浙江杭州310013

出　　处：《中国现代医生》2019年第10期12-16,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2014KYB002)

摘　　要：目的观察西格列汀对初发2型糖尿病患者颈动脉内膜中层厚度(c-IMT)及血清hs-CRP、IL-6水平的影响。方法选取在我院门诊及住院的初发2型糖尿病患者65例。随机分为磷酸西格列汀片组(实验组)35例和盐酸二甲双胍片组(对照组)30例。所有患者均进行糖尿病健康教育、指导饮食及运动。所有患者治疗前及治疗后6个月均在空腹≥10 h状态下抽取静脉血测定以下指标水平:FPG、2 hPG、hs-CRP、IL-6、TC、TG、HDL-c、LDL-c、HbA1c、hs-CRP、IL-6等,并测定c-IMT。结果两组治疗前血糖、血脂、炎症指标及c-IMT比较差异无统计学意义(P>0.05);两组治疗后FPG、2 hPG、HbA1c较治疗前明显降低,差异有统计学意义(P<0.01),两组间FPG、HbA1c差异有统计学意义(P<0.01),餐后2 h血糖组间差异无统计学意义(P>0.05)。实验组治疗后c-IMT、hs-CRP、IL-6较治疗前明显降低,差异有统计学意义(P<0.05)。对照组治疗后c-IMT变化不明显(P>0.05),hs-CRP及IL-6较治疗前有降低趋势,差异无统计学意义(P>0.05),两组治疗后c-IMT、hs-CRP、IL-6差异有统计学意义(P<0.05)。Spearman直线相关分析:c-IMT与hs-CRP水平及IL-6呈正相关(r=0.6585, P=0.000; r=0.571,P=0.000)。与空腹血糖及糖化血红蛋白无明显相关性(P>0.05)。结论 DPP-4抑制剂西格列汀降糖效应明确,同时能减少c-IMT、hs-CRP、IL-6水平,降糖外的抗炎作用可能参与减少糖尿病患者动脉粥样硬化发生。Objective To observe the effect of sitagliptin on carotid intima-media thickness(c-IMT)and serum hs-CRP and IL-6 levels in the patients with newly diagnosed type 2 diabetes mellitus.Methods 65 patients with newly diagnosed type 2 diabetes mellitus who were admitted to the outpatient clinic and were hospitalized in our hospital were selected.They were randomly divided into sitagliptin phosphate tablet group(experimental group)with 35 cases and metformin hydrochloride tablet group(control group)with 30 cases.All patients were given health education about diabetes,diet guidance and exercise.All patients were given drawing of venous blood at a fasting condition≥10 h before treatment and 6 months after treatment to determine the following indicators:FPG,2hPG,hs-CRP,IL-6,TC,TG,HDL-c,LDL-c,HbA1c,hs-CRP,IL-6,etc,and c-IMT was determined.Results There was no statistically significant difference in blood glucose,blood lipids,inflammation index and c-IMT between the two groups before treatment(P>0.05);after treatment,FPG,2hPG and HbA1c were significantly lower than those before treatment in both groups,and the difference was statistically significant(P<0.01).There were statistically significant differences in FPG and HbA1c between the two groups(P<0.01).There was no statistically significant difference in 2-hour postprandial blood glucose between groups(P>0.05).The c-IMT,hs-CRP and IL-6 levels in the experimental group after treatment were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).There was no significant change in c-IMT in control group after treatment(P>0.05).hs-CRP and IL-6 had a decreasing trend compared with those before treatment,and the difference was not statistically significant(P>0.05).There were statistically significant differences in c-IMT,hs-CRP and IL-6 between the two groups after treatment(P<0.05).Spearman linear correlation analysis:c-IMT was positively correlated with hs-CRP levels and IL-6(r=0.6585,P=0.000;r=0.571,P=0.000).There was no si

关 键 词：西格列汀 2型糖尿病 颈动脉内膜中层厚度 白细胞介素6 高敏C反应蛋白 

分 类 号：R587.1[医药卫生—内分泌]