恩格列净联合二甲双胍治疗老年2型糖尿病患者的临床疗效对IL-17A、IL-22、IFN-γ水平的影响  

Influence of Empagliflozin Combined with Metformin on IL-17A,IL-22,IFN-γ Levels in Elderly Patients with Type 2 Diabetes

作　　者：赵香芳[1] 常连庆[1] 吕春雷[1] 刘乃琴[1] 王喻[1] ZHAO Xiang-fang;CHANG Lian-qing;LYU Chun-lei(Department of cadre ward,Tianjin rehabilitation and recuperation center,Tianjin 300381)

机构地区：[1]中国人民解放军天津康复疗养中心干部病房科,天津300381

出　　处：《医学临床研究》2021年第5期720-723,共4页Journal of Clinical Research

摘　　要：【目的】探讨恩格列净联合二甲双胍治疗2型糖尿病(T2DM)老年患者的临床疗效及对白细胞介素-17A(IL-17A)、IL-22、干扰素-γ(IFN-γ)水平的影响。【方法】选取2020年1〜7月在本院诊治的T2DM老年患者108例,按照随机数表法分为观察组和对照组,每组54例。对照组采用二甲双胍治疗,观察组在对照组基础上加用恩格列净治疗,均治疗3个月。比较两组临床疗效及治疗前后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbAlc)]、胰岛功能指标[空腹胰岛素(FINS)、餐后2 h胰岛素(PINS)、胰岛素抵抗指数(HOMA-IR)、胰岛p细胞功能指数(HOMA-β)]、IL-17 A、IL-22、IFN-γ水平、血脂[低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、总胆固醇(TC)]、血压[舒张压(DBP)、收缩压(SBP)]和不良反应发生率。【结果】观察组总有效率为94.44%(51/54),显著高于对照组的81.48%(44/54),其差异有统计学意义(χ^(2)=4.285,P=0.038);治疗1个月、3个月后,观察组FPG、2hPG、HbA1 c、HOMA-IR、IL-17A、IL-22、IFN-γ、LDL-C、TG、TC、DBP、SBP水平显著低于对照组,HOMA-β、FINS、PINS、HDL-C水平显著高于对照组,其差异均有统计学意义(P<0.05);观察组不良反应发生率为9.26%(5/54),与对照组的5.56%(3/54)比较差异无统计学意义(χ^(2)=0.135,P=0.713)。【结论】二甲双胍联合恩格列净治疗老年T2DM可有效降低血糖,改善胰岛功能、血脂、血压,下调IL-17A、IL-22、IFN-γ水平,提高临床疗效,且安全性高,值得临床推广应用。【Objective】To investigate the efficacy of empagliflozin combined with metformin in the treatment of elderly patients with type 2 diabetes(T2DM)and their effects on levels of blood glucose,interleukin-17A(IL-17A),IL-22,and interferon-γ(IFN-γ).【Methods】A total of 108 elderly patients with type 2 diabetes in our hospital from January 2020 to July 2020 were selected and divided into the observation group(n=54)and the control group(n=54)based on a simple random number table method.On the basis of routine intervention,patients in the control group received metformin alone for 3 months treatment,while patients in the observation group received both metformin and empagliflozin for 3 months.The clinical efficacy,blood glucose indicators fasting blood glucose(FPG),2 h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],islet function indicators fasting insulin(FINS),2 h postprandial insulin(PINS),insulin resistance index(HOMA-IR),pancreatic islet p cell function index(HOMA-β)],IL-17A,IL-22,IFN-γ levels,blood lipids[low density lipoprotein cholesterol(LDL-C),High-density lipoprotein cholesterol(HDL-C),triacylglycerol(TG).total cholesterol(TC)],blood pressure[diastolic blood pressure(DBP),systolic blood pressure(SBP)],BMI before and af-ter treatment,and the incidence of adverse reactions were calculated and compared between the two groups.【Results】The total effective rate of the observation group(94.44%)was higher than that of the control group(81.48%)(P<0.05).The levels of FPG,2hPG,HbAlc HOMA-IR,IL-17A,IL-22,IFN-γ,LDL-C,TG,TC,DBP,and SBP in the observation group were lower than those in the control group after 1 month and 3 months of treatment(P<0.05);While after 1 month and 3 months of treatment,the levels of HOMA-β,FINS,HDL-C and PINS in the observation,group were higher than those in the control group,the differences were all statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group(9.26%)and the control group(5

关 键 词：糖尿病 2型/药物疗法 二甲双胍/药理学 降血糖药/药理学 白细胞介素17/血液 干扰素γ//血液 老年人 

分 类 号：R587.1[医药卫生—内分泌]