摘要
目的观察前列地尔联合利拉鲁肽对2型糖尿病(T2DM)患者肾功能、血管功能及血脂代谢水平的影响并探索其机制。方法选取2015年12月—2018年6月辽宁省金秋医院内分泌代谢科收治的2型糖尿病患者96例作为研究对象,按照随机数字表法分为对照组48例和观察组48例。对照组予以饮食指导、适当锻炼以及利拉鲁肽治疗;观察组在对照组基础上给予前列地尔,2组均治疗8周。比较2组患者治疗前后血糖、血脂、C肽、肾功能、血清Vaspin与内抑素(ENS)水平以及血管功能等指标。结果治疗后,2组患者空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA_(1C))、总胆固醇(TC)、三酰甘油(TG)、尿素氮(BUN)、血肌酐(SCr)及24 h尿蛋白均较治疗前下降(P<0.01),且观察组下降幅度大于对照组(t/P=6.762/0.000、 4.695/0.000、6.264/0.000、5.185/0.000、4.221/0.000、3.902/0.000、2.324/0.022、3.769/0.000);2组患者空腹C肽、餐后2 h C肽较治疗前均升高(P<0.01),且观察组高于对照组(t/P=2.088/0.039、8.218/0.000);2组患者血清Vaspin及ENS水平均高于治疗前(P<0.01),且观察组均高于对照组(t/P=9.758/0.000、24.800/0.000);2组患者下肢血管IMT、PSV、狭窄率均低于治疗前(P<0.01),且观察组各指标优于对照组(t/P=8.506/0.000、4.281/0.000、3.552/0.001);2组患者均未发生严重不良反应事件。结论前列地尔联合利拉鲁肽治疗2型糖尿病疗效显著,可有效控制血糖、血脂,改善胰岛β细胞功能,同时有助于改善患者肾功能和血管功能,平衡Vaspin和ENS的表达,具有积极的临床意义。
Objective To observe the curative effect of alprostadil combined with liraglutide on renal and vascular functions and lipid metabolism in patients with T2 DM and explore its mechanism. Methods Ninety-six patients with type 2 diabetes admitted to the Department of Endocrinology and Metabolism, Jinqiu Hospital of Liaoning Province from December2015 to June 2018 were selected as the study subjects. According to the method of random number table, they were divided into control group(48 cases) and observation group(48 cases). The control group was given dietary guidance, proper exercise and liraglutide treatment. The observation group was given alprostadil on the basis of the control group. Both groups were treated for 8 weeks. Blood sugar, blood lipid, C-peptide, renal function, serum levels of Vaspin and ENS and vascular function were compared between the two groups before and after treatment. Results After treatment, fasting blood glucose(FPG), postprandial 2 h blood glucose(2 h PG), glycohemoglobin(HbA1 C), total cholesterol(TC), triglyceride(TG),urea nitrogen(BUN), blood Creatinine(SCr) and 24 h urinary protein were lower than before treatment, and the decrease in the observation group was greater than that in the control group(t/P = 6. 762/0. 000, t/P =4. 695/0.000, t/P = 6. 264/0.000, t/P =5.185/0.000, t/P =4.221/0.000, t/P = 3.902/0.000, t/P= 2.324/0.022, t/P =3.769/0.000); fasting C peptide in 2 groups of patients, 2 h after meal The C-peptide was higher than that before treatment, and the observation group was higher than the control group(t/P = 2.088/0.039, t/P = 8.218/0.000). The serum levels of Vaspin and ENS in the two groups were higher than before treatment. The observation group was higher than the control group(t/P = 9. 758/0.000, t/P =24.800/0.000); the IMT, PSV and stenosis rate of the lower extremity vessels of the two groups were lower than that before treatment, and the indicators of the observation group were better than the observation group. The control group(t/P = 8. 506/0. 000, t/P =4. 281/0. 000, t/P = 3. 552/0. 001); no serious adverse events occurred in the two groups. Conclusion Alprostadil combined with liraglutide in the treatment of type 2 diabetes mellitus has a significant effect. It can effectively control the metabolism of blood glucose and lipid, improve the function of islet beta cells, improve renal and vascular functions, balance the expression of Vaspin and ENS, and has a positive clinical significance.
引文
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