| 奚宁宁,周莉,乔松,等.西格列汀对糖尿病病人心脏舒张功能和心肌纤维化的影响[J].安徽医药,2021,25(5):1044-1047. |
| 西格列汀对糖尿病病人心脏舒张功能和心肌纤维化的影响 |
| Effect of sitagliptin on diastolic function and myocardial fibrosis in diabetic patients |
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| DOI：10.3969/j.issn.1009-6469.2021.05.050 |
| 中文关键词: 糖尿病 西格列汀 心脏舒张功能 心肌纤维化 |
| 英文关键词: Diabetes mellitus Sitagliptin Diastolic function Myocardial fibrosis |
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| 中文摘要: |
| 目的探讨西格列汀对糖尿病病人心脏舒张功能和心肌纤维化的影响。方法选取 2016年 3月至 2018年 3月在黑龙江省康复医院就诊的糖尿病病人 84例，随机数字表法分为对照组与观察组，各 42例。观察组采取西格列汀治疗，对照组采取非西格列汀治疗。比较两组心脏舒张功能与心肌纤维化指标的变化。结果两组治疗 12个月后空腹血糖( FBG)［对照组(5.22±1.10)mmol/L比( 10.98±2.25)mmol/L、观察组( 5.20±0.98)mmol/L比( 10.72±2.35)mmol/L］、糖化血红蛋白( HbA1c)［对照组(6.68±1.53)mmol/L比( 8.74±2.55)mmol/L、观察组( 6.92±1.85)mmol/L比( 8.88±2.52)mmol/L］、组织金属蛋白酶抑制剂 -1(TIMP1)［对照组( 133.1±40.6)ng/mL比( 212.2±55.6)ng/mL、观察组(685.4±88.6)ng/mL比( 223.5±52.3)ng/mL］B型脑钠肽(BNP)［对照组( 2 958.6±188.7)pg/mL比(2 115.5±125.6)pg/mL、观察组( 755.6±88.7)pg/mL比(2095.7±115.3)pg/mL］、、半乳糖凝集素 -3(Gal-3)［对照组(36.54±3.32)ng/mL比(18.96±1.65)ng/mL、观察组( 11.52±1.22)ng/mL比(18.66±1.52)ng/mL］明显优于治疗前，差异有统计学意义( P<0.05)；观察组治疗后 BNP、TIMP-1、Gal-3指标明显优于对照组，差异有统计学意义( P<0.05)。观察组治疗后左心室前后径( LAD)［(31.25±3.65)mm比( 37.65±3.32)mm］、左心房前后径( LVD)［( 41.05±3.32)mm比( 45.25±4.38)mm］、左心室舒张期后壁厚度( LVPW)［( 9.89±0.88)mm比( 11.33±0.86)mm］、左心室重量指数( LVMI)［( 57.39±6.65)g/m2比( 65.34±6.28)g/m2］明显低于对照组，左心室射血分数( LVEF)［(68.58±8.95)%比( 61.25±8.36)%］、舒张早期左心室充盈峰速率与心房收缩期左心室充盈峰速率比值( E/A)［(1.39±0.29)比( 1.21±0.20)］明显高于对照组，差异有统计学意义( P<0.05)。观察组病人在治疗期间出现的不良反应发生率 14.29%，低于对照组的 42.86%，差异有统计学意义( P<0.05)。结论西格列汀能有效缓解糖尿病病人的心脏舒张功能，缓解心肌纤维化的发展，安全性高，值得临床推广。 |
| 英文摘要: |
| Objective To investigate the effect of sitagliptin on diastolic function and myocardial fibrosis in diabetic patients.Meth? ods Eighty-four patients with diabetes mellitus admitted to Heilongjiang Rehabilitation Hospital from March 2016 to March 2018were enrolled and divided into control group and observation group according to the random number table method, with 42 cases each.The observation group was treated with sitagliptin and the control group was treated with non-sitagliptin. Changes in diastolic function and myocardial fibrosis were compared between the two groups.Results Twelve months after treatment, FBG [the control group (5.22± 1.10) mmol/L vs. (10.98±2.25) mmol/L, the observation group (5.20±0.98) mmol/L vs. (10.72±2.35) mmol/L], HbA1c [the control group (6.68±1.53) mmol/L vs. (8.74±2.55) mmol/L, the observation group (6.92±1.85) mmol/L vs. (8.88±2.52) mmol/L], BNP [the control group (2 958.6±188.7) pg/mL vs. (2 115.5±125.6) pg/mL, the observation group (755.6±88.7) pg/mL vs. (2095.7±115.3) pg/mL], TIMP-1 [the control group (133.1±40.6) ng/mL vs. (212.2±55.6) ng/mL, the observation group (685.4±88.6) ng/mL vs. (223.5±52.3) ng/mL], Gal-3[the control group (36.54±3.32) ng/mL vs. (18.96±1.65) ng/mL, the observation group (11.52±1.22) ng/mL vs. (18.66±1.52) ng/mL] were significantly better than those before treatment, the differences were statistically significant (P<0.05); BNP, TIMP-1, Gal after treatment inthe observation group were significantly better than those of the control group, and the differences were statistically significant (P<0.05). The LAD [(31.25±3.65) mm vs. (37.65±3.32) mm], LVD[(41.05±3.32) mm vs. (45.25±4.38) mm], LVPW[(9.89±0.88) mm vs. (11.33± 0.86) mm] and LVMI [(57.39±6.65) g/m2 vs. (65.34±6.28) g/m2] indexes of the observation group were significantly lower than those of the control group. The LVEF [(68.58±8.95) % vs. (61.25±8.36) %] and E/A [(1.39±0.29) vs. (1.21±0.20)] indexes were significantly higher than the control group, and the difference was statistically significant (P<0.05).Conclusion Sitagliptin can effectively relieve the diastolic function of diabetic patients and alleviate the development of myocardial fibrosis, which is worthy of clinical application. |
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