降糖速度对2型糖尿病合并冠心病患者肌酸激酶同工酶和肌红蛋白的影响

The influence of glucose-lowering rate on CKMB and muscle hemoglobin in type 2 diabetes mellitus with coronary heart disease

通过对151例2型糖尿病合并冠心病（T2DMC）患者和142例2型糖尿病患者在降糖过程中肌酸激酶同工酶（CKMB）和肌红蛋白水平变化的研究，寻找2型糖尿病患者合理的降糖速度。2型糖尿病组CKMB水平在随访时较降糖前后均下降（P〈0．05），当空腹或餐后2h降糖速度≤6mmol·L^-1·d^-1时，CKMB与肌红蛋白水平随访时较降糖前均有显著下降（P〈0．05），当空腹降糖速度〉6mmol·L^-1·d^-1时，CKMB水平降糖后较降糖前显著升高（P〈0．05）；T2DMC组空腹或餐后2h降糖速度≤4mmol·L^-1·d^-1时，CKMB与肌红蛋白水平随访时较降糖前显著下降（P〈0．05或P〈O．01），当空腹降糖速度〉4mmol·L^-1·d^-1时，CKMB与肌红蛋白水平随访时较降糖前显著升高（P〈0．05）。

One hundred and fifty-one type 2 diabetic patients with coronary heart disease （ T2 DMC ） and 142 cases of type 2 diabetes mellitus were included for analyzing the influence of different glucose-lowering rates on MB isoenzyme of creatine kinase （ CKMB ） and muscle hemoglobin level changes to search for the rational glucose-lowering rate. The level of CKMB in type 2 diabetes mellitus group was significantly lower（ P〈O. 05 ） at follow-up than thatbefore and after intensive therapy. In type 2 diabetes mellitus group, when the fasting or postprandial glucose-lowering rate was not greater than 6 mmol·L^-1·d^-1, the level of CKMB and muscle hemoglobin were significantly lower at follow-up than that before intensive therapy （ P 〈 0.05 ）. When the fasting glucose-lowering rate is greater than 6 mmol·L^-1·d^-1, the level of CKMB is significantly higher after intensive therapy than that before glucose-lowering （P〈0.05）. In T2DMC group, when the fasting or postprandial glucose-lowering rate was not greater than 4 mmol·L^-1·d^-1, the level of CKMB and muscle hemoglobin was significantly lower at follow-up than that before intensive therapy（ P〈0.05 or P〈O. 01 ）, but higher at follow-up when the fasting glucose-lowering rate was greater than 4 mmol·L^-1·d^-1（P〈O. 05 ）.