G-CSF对2型糖尿病合并心力衰竭患者心肌能量代谢变化的影响

Influences of granulocyte colony stimulating factor on myocardial energy expenditure in patients with type 2 diabetes mellitus complicating heart failure

目的观察粒细胞集落刺激因子(G-CSF)对2型糖尿病合并心力衰竭患者心肌能量代谢(MEE)的影响。方法纳入59例2型糖尿病合并心力衰竭患者,分为对照组(常规治疗,n=28)和观察组(常规治疗+G-CSF治疗,n=31),治疗3个月后观察临床总有效率、血浆B型钠尿肽(BNP)、血清乳酸(LAC)水平,以及多普勒超声心动图检测并计算左心室收缩、舒张、整体功能指标及MEE。结果观察组总有效率为90.3%,对照组总有效率为78.5%,两组比较差异有统计学意义(P<0.05)。治疗后两组患者血浆BNP、LAC水平较治疗前均有下降,观察组下降较对照组更加明显(P<0.05)。两组治疗后心功能各项参数较治疗前均有改善(P<0.05);观察组与对照组相比,左心室射血分数(LVEF)、左心室收缩末圆周室壁应力(cESS)、MEE等指标变化明显,差异有统计学意义(P<0.05)。结论 G-CSF治疗2型糖尿病合并心力衰竭患者,血浆BNP、LAC水平降低,心功能改善,心肌的能量消耗明显降低。

Objective To observe the influences of granulocyte colony stimulating factor（G-CSF）on the myocardial energy ex-penditure（MEE）in the patients with type 2 diabetes mellitus（T2DM）complicating heart failure（HF）.Methods 59 patients with T2DM complicating HF（n=59）were selected and randomly divided into the control group（treated with routine therapy,n=28） and the observation group（treated with routine therapy and G-CSF,n=31）.After 3-months treatment,the total effective rate,plas-ma BNP level and blood lactate（LAC）levels were observed.The Doppler ultrasonography was performed and the left ventricular systolic,diastolic and overall functional indexes and MEE were calculated for evaluating the relationship between MEE,LEVF and LVFS with patients.Results The total effective rate was 90.3% in the observation group and 78.5% in the control group with statistical difference between the two groups（P＆lt;0.05）.The levels of plasma BNP and LAC were decreased in the two groups after the treatment,but which in the observation group were more significant（P＆lt;0.05）.The ultrasonography parameters of cardiac function after treatment were improved in the two groups（P＆lt;0.05）;compared with the control group,the improvement of LVEF, cESS,MEE,etc.in the observation group were more significant,the differences had statistical significance（P＆lt;0.05）.Conclusion G-CSF can significantly decrease the levels of plasma BNP and LAC,improve the cardiac function and reduce the myocardial energy expenditure in treating T2DM complicating HF.