体外反搏对于冠心病合并糖尿病患者的疗效观察
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摘要
目的:观察体外反搏(external counterpulsation,ECP)对冠心病合并糖尿病患者尿微量白蛋白、胰岛素样生长因子-1表达的影响,并探讨其可能的作用机制。
方法:2005年9月至2007年1月本院收治120例糖尿病(DM)并冠心(CAD)患者。将患者随机分为反搏组(63例)和对照组(57例)。反搏组给予常规治疗加体外反搏治疗(体外反博方法见下),心绞痛发作时可含化硝酸甘油控制症状。对照组采用常规药物治疗,加用消心痛和阿替洛尔合用者30例,单加用消心痛者27例。消心痛剂量每日30-60mg,阿替洛尔每日12.5-50 mg,并配合应用其他药物治疗,血糖由降糖药物控制,不给予胰岛素治疗。在反搏治疗36天后,即三个疗程,分别统计每例患者性别、年龄、血压、心率、胆固醇、甘油三酯、空腹静脉血糖、尿微量白蛋白含量、胰岛素样生长因子-1(IGF-1),并行12导联心电图(ECG)检查等,用以评价体外反搏术对于冠心病及糖尿病的延缓及治疗作用。
结果:与对照组相比,体外反搏能明显降低冠心病合并糖尿病患者血压、血糖、胆固醇,尿微量白蛋白明显减少,胰岛素样生长因子-1明显增加,差别均具有高度统计学意义(p＜0.01),也能降低患者甘油三酯水平,差异也具有统计学意义(p＜0.05)。
结论:本研究发现体外反博有抑制冠心病合并糖尿病患者尿白蛋白的排泄,促进胰岛素样生长因子-1的分泌的作用,从而降低血糖,改善肾小球滤过功能,这可能是体外反博治疗冠心病合并糖尿病患者有效的机制之一。
[Objective] To investigate the effects of ECP (external counterpulsation, ECP) on urinary albumin, insulin-like growth factor-1 expression in patients with coronary artery disease and diabees, and to probe into its possible mechanism.
[Methods] 120 patients who was accepted in qingdao medical college affiliated hospital with the diseases of diabetes mellitus (DM) and coronary artery disease (CAD) patients from September 2005 to January 2007 were collected. The patients were randomly divided into counterpulsation group (63 cases) and the control group (57 cases). Patients in counterpulsation group were given external counterpulsation treatment (method of external counterpulsation as follow), when angina attack only were given nitroglycerin to control symptoms . Patients in the control group were given routine medication, 30 Patients were treated with both isosorbide dinitrate and Atenolol, while 27 cases were treated with isosorbide dinitrate. The dose of isosorbide dinitrate was 30-60mg/d, the dose of Atenolol was 12.5-50mg/d, and combined with the treatment of other drugs, blood sugar was controled by hypoglycemic drugs, but not given insulin therapy. After 36 days of counterpulsation treatment , which was three courses of treatment, to collect statistics respectively containing gender, age, blood pressure, heart rate, cholesterin, triglyeride, fasting venous blood sugar, urine microalbumin levels , insulin-like growth factor-1 (IGF-1),and electrocardiogram (ECG ) inspection to evaluate the treatment of ECP on patients with coronary heart disease and diabetes and.
[ Results ] Compared with the control group, ECP can significantly decreased blood pressure、blood sugar、cholesterin and cholesterin in patients with coronary heart disease and diabetes, and significantly increase insulin-like growth factor-1, and the difference were statistically significant (p <0.01). ECP can reduced triglyceride levels, and the difference was significant (p <0.05).
[ Conclusion ]
In this study ,we found external counterpulsation inhibite the excretion of urinary albumin excretion and promote insulin-like growth factor-1 secretion of the patients with coronary heart disease and diabetes mellitus, thereby to reduce blood glucose, improve glomerular filtration rate, which may be the effective mechanism of external counterpulsation in treating patients with coronary heart disease.
方法:2005年9月至2007年1月本院收治120例糖尿病(DM)并冠心(CAD)患者。将患者随机分为反搏组(63例)和对照组(57例)。反搏组给予常规治疗加体外反搏治疗(体外反博方法见下),心绞痛发作时可含化硝酸甘油控制症状。对照组采用常规药物治疗,加用消心痛和阿替洛尔合用者30例,单加用消心痛者27例。消心痛剂量每日30-60mg,阿替洛尔每日12.5-50 mg,并配合应用其他药物治疗,血糖由降糖药物控制,不给予胰岛素治疗。在反搏治疗36天后,即三个疗程,分别统计每例患者性别、年龄、血压、心率、胆固醇、甘油三酯、空腹静脉血糖、尿微量白蛋白含量、胰岛素样生长因子-1(IGF-1),并行12导联心电图(ECG)检查等,用以评价体外反搏术对于冠心病及糖尿病的延缓及治疗作用。
结果:与对照组相比,体外反搏能明显降低冠心病合并糖尿病患者血压、血糖、胆固醇,尿微量白蛋白明显减少,胰岛素样生长因子-1明显增加,差别均具有高度统计学意义(p＜0.01),也能降低患者甘油三酯水平,差异也具有统计学意义(p＜0.05)。
结论:本研究发现体外反博有抑制冠心病合并糖尿病患者尿白蛋白的排泄,促进胰岛素样生长因子-1的分泌的作用,从而降低血糖,改善肾小球滤过功能,这可能是体外反博治疗冠心病合并糖尿病患者有效的机制之一。
[Objective] To investigate the effects of ECP (external counterpulsation, ECP) on urinary albumin, insulin-like growth factor-1 expression in patients with coronary artery disease and diabees, and to probe into its possible mechanism.
[Methods] 120 patients who was accepted in qingdao medical college affiliated hospital with the diseases of diabetes mellitus (DM) and coronary artery disease (CAD) patients from September 2005 to January 2007 were collected. The patients were randomly divided into counterpulsation group (63 cases) and the control group (57 cases). Patients in counterpulsation group were given external counterpulsation treatment (method of external counterpulsation as follow), when angina attack only were given nitroglycerin to control symptoms . Patients in the control group were given routine medication, 30 Patients were treated with both isosorbide dinitrate and Atenolol, while 27 cases were treated with isosorbide dinitrate. The dose of isosorbide dinitrate was 30-60mg/d, the dose of Atenolol was 12.5-50mg/d, and combined with the treatment of other drugs, blood sugar was controled by hypoglycemic drugs, but not given insulin therapy. After 36 days of counterpulsation treatment , which was three courses of treatment, to collect statistics respectively containing gender, age, blood pressure, heart rate, cholesterin, triglyeride, fasting venous blood sugar, urine microalbumin levels , insulin-like growth factor-1 (IGF-1),and electrocardiogram (ECG ) inspection to evaluate the treatment of ECP on patients with coronary heart disease and diabetes and.
[ Results ] Compared with the control group, ECP can significantly decreased blood pressure、blood sugar、cholesterin and cholesterin in patients with coronary heart disease and diabetes, and significantly increase insulin-like growth factor-1, and the difference were statistically significant (p <0.01). ECP can reduced triglyceride levels, and the difference was significant (p <0.05).
[ Conclusion ]
In this study ,we found external counterpulsation inhibite the excretion of urinary albumin excretion and promote insulin-like growth factor-1 secretion of the patients with coronary heart disease and diabetes mellitus, thereby to reduce blood glucose, improve glomerular filtration rate, which may be the effective mechanism of external counterpulsation in treating patients with coronary heart disease.
引文
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