达格列净联合二甲双胍治疗T2DM合并冠心病患者的效果及对TGF-β1/Smads通路的影响  

Effect of dapagliflozin combined with metformin in the treatment of T2DM patients with coronary heart disease and its influence on TGF-β1/Smads pathway

作　　者：葛钻敏 骆超 陈光明 朱迪 陈跃华 GE Zuanmin;LUO Chao;CHEN Guangming(Department of Gen-eral Medicine,Jinhua Hospital Affiliated to Zhejiang University School of Medicine,Jinhua 321000,China)

机构地区：[1]浙江大学医学院附属金华医院全科医学科,浙江金华321000

出　　处：《全科医学临床与教育》2025年第3期207-210,218,共5页Clinical Education of General Practice

基　　金：金华市科技计划项目(2021-3-055)。

摘　　要：目的 分析达格列净联合二甲双胍治疗2型糖尿病(T2DM)合并冠心病患者的效果及对转化生长因子β1(TGF-β1)/Smads通路的影响。方法 回顾性选取96例T2DM合并冠心病患者作为研究对象,根据不同的治疗方案分为联合组(n=49)与对照组(n=47)。对照组给予二甲双胍治疗,联合组在对照组的基础上给予达格列净治疗,均治疗4周。比较两组治疗前后的空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、D-二聚体(D-D)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、TGF-β1、Smads3及Smads7mRNA水平;比较两组不良反应发生情况。结果联合组治疗后的FPG、HbA1c、TC、TG、LDL-C、D-D、TGF-β1mRNA、Smads3mRNA均低于对照组(t分别=2.87、2.14、2.95、3.14、2.86、3.16、4.28、4.98,P均<0.05);联合组治疗后的HDL-C、TT、PT、APTT及Smads7mRNA均高于对照组(t分别=-2.75、-2.93、-3.10、-3.04、-3.06,P均<0.05);两组不良反应比较,差异无统计学意义(χ^(2)=0.24,P>0.05)。结论 达格列净联合二甲双胍治疗T2DM合并冠心病患者,能够降低血糖和血脂水平,改善凝血功能,其作用机制可能与TGF-β1/Smads通路相关。Objective To analyze the effect of dapagliflozin combined with metformin in the treatment of patients with type 2 diabetes mellitus(T2DM)and coronary heart disease and its effect on transforming growth factor β1(TGF-β1)/Smads pathway.Methods A total of 96 T2DM patients with coronary heart disease were retrospectively selected and were divided into a combination group(n=49)and a control group(n=47)according to different treatment plans.The control group was treated with metformin,and the combined group was treated with dapagliflozin on the basis of the control group.The course was 4 weeks.The fasting plasma glucose(FPG),hemoglobin A1c(HbA1c),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),Ddimer(D-D),thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),TGF-β1,Smads3 and Smads7mRNA levels were compared between the two groups before and after treatment.The occurrence of adverse reactions was compared between the two groups.Results After treatment,FPG,HbA1c,TC,TG,LDL-C,D-D,TGF-β1mRNA and Smads3mRNA in combination group were lower than those in control group(t=2.87,2.14,2.95,3.14,2.86,3.16,4.28,4.98,P<0.05).The HDL-C,TT,PT,APTT and Smads7mRNA levels in combination group were higher than those in control group(t=-2.75,-2.93,-3.10,-3.04,-3.06,P<0.05).There was no significant difference in adverse reactions between two groups(χ^(2)=0.24,P>0.05).Conclusion Dapagliflozin combined with metformin in the treatment of T2DM patients with coronary heart disease can reduce blood glucose and lipid levels and improve coagulation function,the mechanism of which may be related to TGF-β1/Smads pathway.

关 键 词：2型糖尿病 冠心病 达格列净 二甲双胍 转化生长因子β1/Smads通路 

分 类 号：R58[医药卫生—内分泌]