恩格列净治疗老年糖尿病的临床疗效及对心血管危险因素作用
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摘要
目的探讨恩格列净治疗老年糖尿病的临床疗效及对心血管危险因素作用。方法选取2017年1—12月上海市嘉定区南翔医院收治的160例老年糖尿病患者随机分为两组,每组各80例,其中,对照组给予二甲双胍,治疗组给予恩格列净联合二甲双胍,疗程均为6个月。比较两组患者血糖指标、心血管危险因素指标的变化,并记录治疗期间不良反应的发生情况。结果治疗后,两组各血糖相关指标均显著下降,治疗组的下降幅度明显高于对照组(P<0.05);治疗后,治疗组患者收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)等指标水平均明显降低,HDL-C明显升高(P<0.05)。治疗组低血糖事件、尿路感染的发生率分别为5.0%、11.3%,对照组分别为3.8%、8.8%。两组各不良反应发生率比较,差异均无统计学意义(P>0.05)。结论恩格列净联合二甲双胍治疗老年2型糖尿病(T2DM)安全有效,可控制血糖,还可达到降低血压、改善血脂及抗炎作用从而降低心血管疾病的发生风险。
OBJECTIVE To explore the clinical efficacy and cardiovascular risk factors of engliadine in the treatment of elderly diabetes mellitus. METHODS 160 patients with elderly diabetes mellitus received treatment from January 2017 to December 2017 were divided into two groups,which were given metformin(control group,80 cases)and empagliflozin + metformin(treatment group,80 cases). All the treatment course was 6 months. The changes of blood glucose index and cardiovascular risk factor index were compared between these two groups,and the adverse reactions during treatment were recorded. RESULTS After treatment,related parameters of blood glucose in two groups were reduced significantly,the decline of treatment group was obviously higher than control group(P<0.05). After treatment,the level of SBP,DBP,TG,TC,LDL-C,CRP and HCY in treatment group were significantly decreased,level of HDL-C was significantly increased(P<0.05). The incidence of hypoglycaemia and urinary tract infection were 5.0% and 11.3% in treatment group,3.8%and 8.8% in control group. There were no significant difference on the incidence of adverse reactions between two groups(P>0.05). CONCLUSION Empagliflozin combined with metformin was safe and effective in the treatment of elderly T2DM,which could control blood glucose,reduce blood pressure,improve blood lipid and anti-inflammatory effects and thus reduce the risk of cardiovascular disease.
OBJECTIVE To explore the clinical efficacy and cardiovascular risk factors of engliadine in the treatment of elderly diabetes mellitus. METHODS 160 patients with elderly diabetes mellitus received treatment from January 2017 to December 2017 were divided into two groups,which were given metformin(control group,80 cases)and empagliflozin + metformin(treatment group,80 cases). All the treatment course was 6 months. The changes of blood glucose index and cardiovascular risk factor index were compared between these two groups,and the adverse reactions during treatment were recorded. RESULTS After treatment,related parameters of blood glucose in two groups were reduced significantly,the decline of treatment group was obviously higher than control group(P<0.05). After treatment,the level of SBP,DBP,TG,TC,LDL-C,CRP and HCY in treatment group were significantly decreased,level of HDL-C was significantly increased(P<0.05). The incidence of hypoglycaemia and urinary tract infection were 5.0% and 11.3% in treatment group,3.8%and 8.8% in control group. There were no significant difference on the incidence of adverse reactions between two groups(P>0.05). CONCLUSION Empagliflozin combined with metformin was safe and effective in the treatment of elderly T2DM,which could control blood glucose,reduce blood pressure,improve blood lipid and anti-inflammatory effects and thus reduce the risk of cardiovascular disease.
引文
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[7]ROSENSTOCK J,SEMAN L J,JELASKA A,et al.Efficacy and safety of empagliflozin,a sodium glucose cotransporter 2(SGLT 2)inhibitor,as add-on to metformin in type 2 diabetes with mild hyperglycaemia[J].Diabetes obes metab,2013,15(5):1154-1160.
[8]FITCHETT D,ZINMAN B,WANNER C,et al.Heart failure outcomes with empagliflozin in patients with type 2 diabetes at high cardiovascular risk:results of the EMPA-REG OUTCOME?trial[J].Eur heart j,2016,37(19):1526-1534.
[9]ZINMAN B,WANNER C,LACHIN J M,et al.Empagliflozin,cardiovascular outcomes,and mortality in type 2 diabetes[J].N Engl j med,2015,373(22):2117-2128.
[10]房剑英,牛林.恩格列净治疗2型糖尿病安全性的系统评价[J].中国药房,2016,27(33):4679-4681,4682.
[2]WANG T T,LIN B,CUI W X,et al.Clustering of cardiovascular risk factors and diabetes:a prospective cohort study on the Inner Mongolian population in China[J].Biomed environ sci,2018,31(10):749-756.
[3]ZINMAN B,WANNER C,LACHIN J M,et al.Empagliflozin,cardiovascular outcomes,and mortality in type 2 diabetes[J].N Engl j med,2015,373(5):2117-2128.
[4]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):893-942.
[5]YANG W,LI Y,TIAN T,et al.Serum vaspin concentration in elderly patients with type 2 diabetes mellitus and macrovascular complications[J].BMC endocr disord,2017,17(1):67-70.
[6]ZHAO D,LIU H,DONG P.Empagliflozin reduces blood pressure and uric acid in patients with type 2 diabetes mellitus:a systematic review and meta-analysis[J].J hum hypertens,2018,15(11):15-21.
[7]ROSENSTOCK J,SEMAN L J,JELASKA A,et al.Efficacy and safety of empagliflozin,a sodium glucose cotransporter 2(SGLT 2)inhibitor,as add-on to metformin in type 2 diabetes with mild hyperglycaemia[J].Diabetes obes metab,2013,15(5):1154-1160.
[8]FITCHETT D,ZINMAN B,WANNER C,et al.Heart failure outcomes with empagliflozin in patients with type 2 diabetes at high cardiovascular risk:results of the EMPA-REG OUTCOME?trial[J].Eur heart j,2016,37(19):1526-1534.
[9]ZINMAN B,WANNER C,LACHIN J M,et al.Empagliflozin,cardiovascular outcomes,and mortality in type 2 diabetes[J].N Engl j med,2015,373(22):2117-2128.
[10]房剑英,牛林.恩格列净治疗2型糖尿病安全性的系统评价[J].中国药房,2016,27(33):4679-4681,4682.