西格列丁对老年冠心病合并2型糖尿病患者的疗效  

Therapeutic effect of sitagliptin on aged patients with coronary heart disease complicated type 2 diabetes mellitus

作　　者：戴朝博[1] 李瑾 DAI Chao-bo;LI Jin(Department of Geriatrics,First Hospital of Wuhan City,Wuhan,Hubei,430022,China)

机构地区：[1]武汉市第一医院老年病科,湖北武汉430022 [2]武汉市同济医院神经内科

出　　处：《心血管康复医学杂志》2020年第6期676-680,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨西格列丁对老年2型糖尿病(T2DM)合并冠心病(CHD)患者的疗效、安全性及对心功能的作用。方法:根据随机数字表法,2016年3月至2018年2月间我院收治的130例新确诊的老年T2DM合并既往CHD患者被随机均分为常规治疗组(接受二甲双胍治疗)和西格列丁组(接受西格列丁治疗),两组均连续治疗3个月。观察比较两组治疗前后血压、血糖、血脂、心功能指标及不良反应发生情况。结果:与常规治疗组比较,西格列丁组治疗后HOMA-IR[(4.89±2.12)比(3.46±1.65)]、AUC Glu[(48.55±8.90)mmol·L-1·h-1比(43.87±9.24)mmol·L-1·h-1]、FPG[(6.67±3.32)mmol/L比(5.28±3.64)mmol/L]、2hPG[(13.84±3.53)mmol/L比(10.73±3.67)mmol/L]、HbA1c[(7.63±1.57)%比(6.45±1.55)%]、SBP[(130.56±22.32)mmHg比(120.64±22.44)mmHg]、DBP[(71.43±3.98)mmHg比(67.22±3.53)mmHg]、TC[(5.03±0.94)mmol/L比(4.23±1.29)mmol/L]、TG[(2.06±0.61)mmol/L比(1.53±0.56)mmol/L]水平、LVEDd[(61.19±2.78)mm比(58.51±2.99)mm]、LVESd[(49.78±4.27)mm比(42.65±4.22)mm]均显著降低,HOMA-β[(74.74±13.66)%比(82.57±15.98)%]、AUC ins[(193.96±43.75)mmol·L-1·h-1比(213.22±43.43)mmol·L-1·h-1]、LVEF[(39.75±4.64)%比(44.75±5.87)%]均显著升高,P<0.05或<0.01。治疗期间,西格列丁组不良反应总发生率显著低于常规治疗组(9.23%比58.46%),P=0.001。结论:西格列丁应用于2型糖尿病合并冠心病老年患者降低血糖、血脂疗效显著,安全性较高,且显著改善心功能。Objective:To explore therapeutic effect of sitagliptin on aged patients with type 2 diabetes mellitus(T2DM)complicated coronary heart disease(CHD),its safety and influence on cardiac function.Methods:According to random number table method,a total of 130 aged newly diagnosed T2DM+previous CHD patients,who were treated in our hospital from Mar 2016 to Feb 2018,were randomly and equally divided into routine treatment group(received metformin treatment)and sitagliptin group(received sitagliptin treatment),both groups were treated for three months.Blood pressure,blood glucose,blood lipids and cardiac function indexes before and after treatment,and incidence of adverse reactions were observed and compared between two groups.Results:Compared with routine treatment group after treatment,there were significant reductions in levels of HOMA-IR[(4.89±2.12)vs.(3.46±1.65)],AUC Glu[(48.55±8.90)mmol·L-1·h-1 vs.(43.87±9.24)mmol·L-1·h-1],FPG[(6.67±3.32)mmol/L vs.(5.28±3.64)mmol/L],2hPG[(13.84±3.53)mmol/L vs.(10.73±3.67)mmol/L],HbA1c[(7.63±1.57)%vs.(6.45±1.55)%],SBP[(130.56±22.32)mmHg vs.(120.64±22.44)mmHg],DBP[(71.43±3.98)mmHg vs.(67.22±3.53)mmHg],TC[(5.03±0.94)mmol/L vs.(4.23±1.29)mmol/L],TG[(2.06±0.61)mmol/L vs.(1.53±0.56)mmol/L],LVEDd[(61.19±2.78)mm vs.(58.51±2.99)mm]and LVESd[(49.78±4.27)mm vs.(42.65±4.22)mm],and significant rise in HOMA-β[(74.74±13.66)%vs.(82.57±15.98)%],AUC ins[(193.96±43.75)mmol·L-1·h-1 vs.(213.22±43.43)mmol·L-1·h-1],LVEF[(39.75±4.64)%vs.(44.75±5.87)%]in sitagliptin group,P<0.05 or<0.01.During treatment,total incidence rate of adverse reactions in sitagliptin group was significantly lower than that of routine treatment group(9.23%vs.58.46%),P=0.001.Conclusion:Sitagliptin possesses significant effects of lowering blood glucose and blood lipids in aged T2DM+CHD patients with high safety,and it can significantly improve cardiac function.

关 键 词：冠心病 糖尿病 2型 西格列丁 

分 类 号：R541.4[医药卫生—心血管疾病]