2型糖尿病合并高血压患者应用SGLT-2抑制剂后对糖脂代谢及颈动脉重构的影响  

Effects of SGLT-2 Inhibitor on Glucose and Lipid Metabolism and Carotid Artery Remodeling in T2DM Patients with Hypertension

作　　者：庞雅平 姜兰叶[1] 李秀芬[1] 冯金凤[2] PANG Yaping;JIANG Lanye;LI Xiufen;FENG Jinfeng(Department of Endocrinology,The Second Affiliated Hospitalof Hebei North University,Zhangjiakou 075000,China;Department of Function,The Second Affiliated Hospitalof Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第二医院,内分泌科,河北张家口075000 [2]河北北方学院附属第二医院,功能科,河北张家口075000

出　　处：《标记免疫分析与临床》2022年第9期1536-1541,共6页Labeled Immunoassays and Clinical Medicine

基　　金：张家口市重点研发计划项目(编号:2121188D)。

摘　　要：目的探讨钠-葡萄糖协同转运蛋白(SGLT-2)抑制剂治疗对2型糖尿病(T2DM)合并高血压患者糖脂代谢及颈动脉重构的影响,为临床治疗提供参考。方法选择2021年1月至2021年9月我院内分泌科收治的168例T2DM合并高血压患者,随机数字表法将患者分为两组,对照组(84例)采用二甲双胍降糖药治疗,观察组(84例)在对照组基础上给予SGLT-2抑制剂(达格列净)治疗。治疗前、治疗3个月、治疗6个月观察两组糖脂代谢、血压以及颈动脉重构指标的变化和组间差异。结果两组治疗后空腹血糖(FPG)、餐后2h血糖(2hPG)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、收缩压、舒张压、体质量指数、低密度脂蛋白胆固醇(LDL-C)均逐渐降低(P<0.05),观察组治疗后颈总动脉内-中膜厚度(IMT)均逐渐降低(P<0.05),收缩期颈总动脉内径、舒张期颈总动脉内径逐渐增大(P<0.05),对照组IMT、收缩期颈总动脉内径、舒张期颈总动脉内径无明显变化(P>0.05)。观察组治疗3个月、治疗6个月FPG、2hPG、FINS、HOMA-IR、HbA1c、TG、收缩压、舒张压、体质量指数、IMT、LDL-C低于对照组(P<0.05),收缩期颈总动脉内径、舒张期颈总动脉内径大于对照组(P<0.05)。两组不良反应比较差异无统计学差异(P>0.05)。结论SGLT-2抑制剂可在一定程度上改善T2DM合并高血压患者糖脂代谢和颈动脉重构,并具有一定减重和降压作用,安全性较高。Objective To investigate the effects of sodium glucose cotransporter-2(SGLT-2)inhibitor on glucose and lipid metabolism and carotid artery remodeling in patients with type 2 diabetes mellitus(T2DM)complicated with hypertension,and to provide a reference for clinical treatment.Methods A total of 168 T2DM patients with hypertension admitted to the Department of Endocrinology of our hospital from January,2021 to September,2021 were selected for the study.These patients were divided into two groups by random number table method.The control group(84 cases)was treated with metformin and the observation group(84 cases)was treated with Dapagliflozin,a SGLT-2 inhibitor in addition to the baseline treatment.At multiple time points,including before the treatment,3 months,6 months and 12 months after the treatment,the changes of glucose and lipid metabolism,blood pressure and carotid artery remodeling indexes and the differences between the two groups were observed.Results After the treatment,fasting blood glucose(FPG),2h postprandial blood glucose(2hPG),fasting insulin(FINS),homeostasis model insulin resistance index(HOMA-IR),hemoglobin Alc(HbA1c),triglyceride(TG),systolic blood pressure,diastolic blood pressure,body mass index and low-density lipoprotein cholesterol(LDL-C)in both groups decreased gradually(P<0.05).The intima-media thickness(IMT)of the common carotid artery in the observation group decreased gradually after the treatment(P<0.05),while the internal diameter of the common carotid artery in the systolic phase and the internal diameter of the common carotid artery in the diastolic phase increased gradually(P<0.05).There was no significant change in IMT,internal diameter of common carotid artery in systole and diastole in control group(P>0.05).In the observation group,FPG,2hPG,FINS,HOMA-IR,HbA1c,TG,systolic blood pressure,diastolic blood pressure,body mass index,IMT and LDL-C were lower than those in the control group at 3 months,6 months and 12 months after the treatment(P<0.05),while internal diameter of systo

关 键 词：钠-葡萄糖协同转运蛋白 2型糖尿病 高血压 糖脂代谢 颈动脉重构 

分 类 号：R-331[医药卫生] G426[文化科学—课程与教学论]