磷酸西格列汀治疗老年2型糖尿病合并冠心病的临床疗效研究

The study on the effectiveness of sitagliptin phosphate in the treatment of elderly type 2 diabetic patients with coronary heart disease

目的 观察磷酸西格列汀对合并冠心病（coronary heart disease,CHD）的老年2型糖尿病（type 2 diabetes,T2DM）患者各项指标的影响.方法 40例合并CHD的老年T2DM患者在原有治疗的基础上联合磷酸西格列汀治疗,治疗前及治疗4m后分别检测空腹血糖（fast plasma glucose,FPG）、餐后2h血糖（postprandial blood glucose,PBG）、糖化血红蛋白（HbA1c）、血清总胆固醇（total cholesterol,TC）、三酰甘油（triglyceride,TG）;超声心动图检测患者左房（left atrium,LA）、左室（left ventriculus,LV）大小,射血分数（ejection fraction,EF）,24 h血压监测（ambulatory blood pressure monitoring,ABPM）,并比较各项指标的变化.结果 磷酸西格列汀治疗4m后,患者的FPG、PBG、HbA1c值均下降（P＜0.01、P＜0.05和P＜0.01）.治疗后TC无明显变化（P＞0.05）,TG下降（P＜0.05）.LA、LV与治疗前相比无变化（P＞0.05）,EF有所改善（P＜0.05）.治疗期间患者体重差异无统计学意义（P＞0.05）,且无心血管不良反应发生.结论 在合并CHD的老年T2DM患者中应用磷酸西格列汀治疗后,有明确的降糖效果,对心功能无不良反应,还能对患者的TG、EF、BP有轻度的改善作用,可能对患者的预后有益.

Objective To observe the influence of sitagliptin phosphate on the serum indexes in elderly type 2 diabetes （T2DM） patients with coronary heart disease （CHD）. Methods 40 cases of T2DM patients with CHD were treated with sitagliptin phosphate based on former medical therapy. Fast plasma glucose （FPG）, postprandial blood glucose （PBG）, HbAlc, total cholesterol （TC）, and triglyceride （TG） were measured before and after the treatment. Meanwhile, the size of left atrium （LA） and left ventriculus （LV）, and the ejection fraction （EF） were measured by ultrasonic cardiogram and the ambulatory blood pressure monitoring （ABPM） were taken at the same time. Results After 4 months treatment with sitagliptin phosphate, the levels of FPG, PBG, HbAlc decreased （P〈0.01, P〈0.05, P〈0.01, respectively）. TG also decreased （P〈0.05） while TC without change. The sizes of LA and LV had no change, but EFs increased to some extent （P〈0.05）. The body weights of all the patients had no change during the treatment （P〉0.05）, with no reverse event occurred neither. Conclusion The utilizing of sitagliptin phosphate in the treatment of T2DM patients with CHD has obvious positive effectiveness, not only to decrease the level of blood glucose, has no negative effects on the cardiac function, but also can improve condition of TG／EF／BP. It is possibly benefit to the prognosis of the patients.