维格列汀对新诊断2型糖尿病患者血管内皮细胞功能的影响

Effect of Vildagliptin on vascular endothelial cell function in patients with newly diagnosed type 2 diabetes

目的:探讨维格列汀对新诊断2型糖尿病患者血管内皮细胞功能的影响。方法:将2012年1月至2013年6月收治的70例新诊断2型糖尿病患者随机分为维格列汀组和二甲双胍组,每组各35例。治疗前后分别测定患者肱动脉血流介导的血管舒张(FMD)、空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、血脂、脂联素、肿瘤坏死因子α(TNF-α)和C反应蛋白(CRP)。结果:治疗24周后,两组FMD、脂联素均较治疗前增加(P<0.05),Hb A1c、FBG、TG、CHOL、LDL-C、TNF-α、CRP均较治疗前降低(P<0.05);维格列汀组治疗后FINS较治疗前增加(P<0.05),二甲双胍组治疗后FINS与治疗前比较,差异无统计学意义(P>0.05)。其中维格列汀组FMD、脂联素增加,TNF-α降低较二甲双胍组明显(P<0.05);二甲双胍组Hb A1c、FBG、血脂下降较维格列汀组更明显(P<0.05)。结论:维格列汀可改善新诊断2型糖尿病患者血管内皮细胞功能,且这种作用优于二甲双胍。

Objective： To investigate the effect of Vildagliptin on vascular endothelial cell function in patients with newly diagnosed type 2 diabetes. Methods： 70 patients with newly diagnosed type 2 diabetes hospitalized between January 2012 and June 2013 were randomly divided into the Vildagliptin group and Metformin group（ n = 35 each）. Before and after the treatment,flow-mediated dilation（ FMD）,fasting blood glucose（ FBG）,glycated hemoglobin（ HbA1c）,fasting insulin（ FINS）,blood lipid,adiponectin,tumor necrosis factor-α（ TNF-α） and C reactive protein（ CRP） in the brachial artery of patients were determined,respectively. Results： After 24 weeks of treatment,the levels of FMD and adiponectin all significantly increased in the two groups compared with baseline（ P〈0. 05）,while the levels of Hb A1 c,FBG,TG,CHOL,LDL-C,TNF-α and CRP all significantly decreased compared with baseline（ P〈0. 05）. Compared FINS at the baseline,FINS increased after the treatment in the Vildagliptin group（ P〈0. 05）,FINS after the treatment showed no statistically significant difference in the Metformin group（ P〉0. 05）. The increased FMD and adiponectin,and decreased TNF-α in the Vildagliptin group were more significantly than those in the Metformin group（ P〈 0.05）; whereas the decreased Hb A1 c,FBG and blood lipid in the Metformin group were more significantly than those in the Vildagliptin group（ P〈0. 05）. Conclusion： Vildagliptin can improve vascular endothelial cell function in patients with newly diagnosed type 2 diabetes,and has better effect than Metformin.