舒洛地特对2型糖尿病伴慢性阻塞性肺疾病患者血液高凝状态和血管内皮功能的影响  

Effect of Sulodexide on the Hypercoagulable State and Vascular Endothelial Function in Patients with Type 2 Diabetes Mellitus and COPD

作　　者：李红梅 曹向辉 鞠阳 郭同兰[3] LI Hong-mei;CAO Xiang-hui;JU Yang;GUO Tong-lan(Department of Internal Medicine,General Hospital of Jizhong Energy Fengfeng Group Co.,Ltd.,Handan,Hebei 056002,China;Department of Orthopaedics,Handan Hospital,General Hospital of Jizhong Energy Fengfeng Group Co.,Ltd.,Handan,Hebei 056002,China;Department of Endocrinology,the Second People's Hospital of Lianyungang,Lianyungang,Jiangsu 222000,China)

机构地区：[1]冀中能源峰峰集团有限公司总医院邯郸院区内一科,河北邯郸056002 [2]冀中能源峰峰集团有限公司总医院邯郸院区骨科,河北邯郸056002 [3]连云港市第二人民医院内分泌科,江苏连云港222000

出　　处：《解放军医药杂志》2020年第11期54-58,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省卫生厅科技计划项目(20191129)。

摘　　要：目的探讨舒洛地特对2型糖尿病(T2DM)伴慢性阻塞性肺疾病(COPD)患者血液高凝状态及血管内皮功能的影响。方法选取我院2017年1月-2019年12月收治的135例T2DM合并COPD患者为研究对象,按治疗方法分为观察组68例和对照组67例。对照组采取常规综合治疗,观察组在对照组基础上给予舒洛地特治疗;2组均连续治疗2个月。评价COPD疗效,测定2组治疗前后空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、硝酸甘油介导非内皮依赖性血管舒张功能(NMD)及肱动脉血流介导内皮依赖性血管舒张功能(FMD),并统计治疗期间不良反应。结果2组COPD治疗总有效率比较差异无统计学意义(P>0.05);与治疗前比较,2组治疗后FBG、2 h PG、HbA1c、FIB、D-D、hs-CRP、IL-6、TNF-α水平均显著下降,且观察组低于对照组(P<0.05)。与治疗前相比,2组治疗后APTT显著延长,NMD、FMD显著升高,且观察组长于或高于对照组(P<0.05)。2组均未发生不良反应。结论舒洛地特能明显改善T2DM伴COPD患者的血液高凝状态及血管内皮功能,减轻机体炎症反应。Objective To investigate the effect of Sulodexide on the hypercoagulable state and vascular endothelial function in patients with type 2 diabetes mellitus(T2DM)complicated with chronic obstructive pulmonary disease(COPD).Methods According to the treatment method,135 patients with T2DM and COPD who were treated between January 2017 and December 2019 were divided into the observation group(n=68)and the control group(n=67).The control group was given routine comprehensive treatment,and on this basis,the observation group was additionally treated with Sulodexide for 2 months.The curative effect on COPD was evaluated.The fasting blood glucose(FBG),postprandial 2-hour blood glucose(2 h PG),glycated hemoglobin(HbA1c),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(DD),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),nitroglycerin-mediated non-endothelium-dependent vasodilation(NMD)and brachial artery blood flow-mediated endothelium-dependent vasodilation(FMD)in the two groups were determined before and after treatment.Adverse reactions were statistically analyzed.Results There was no significant difference in the total effective rate of treatment for COPD between the two groups(P>0.05).Compared with those before treatment,levels of FBG,2 h PG,HbA1c,FIB,DD,hs-CRP,IL-6 and TNF-αin both groups were decreased significantly after treatment,and the levels were lower in observation group than in control group(P<0.05).APTT was significantly prolonged,NMD and FMD were increased significantly after treatment,and the above indicators in the observation group were significantly better than those in the control group after treatment(P<0.05).No adverse reactions occurred in either group.Conclusion Sulodide can significantly improve the hypercoagulable state and vascular endothelial function and relieve inflammation in patients with T2DM and COPD.

关 键 词：舒洛地特 糖尿病 2型 慢性阻塞性肺疾病 血液高凝 血管内皮功能 白介素-6 肿瘤坏死因子-α 超敏C反应蛋白 

分 类 号：R563.3[医药卫生—呼吸系统] R587.1[医药卫生—内科学]