糖尿病性心肌病患者血清cox-2水平变化及早期药物干预研究

Serum cox-2 level change and early drug interventions in Diabetic cardiomyopathy patients

目的探讨环氧化酶(cox)-2在糖尿病性心肌病发生中的作用,筛选阻止糖尿病性心肌病发生的药物。方法在门诊及住院病房选取120例糖尿病患者为对照组,选取126例糖尿病性心肌病患者为观察组,根据干预措施不同,观察组随机分为常规治疗组(40例),银杏叶组(44例),复方丹参滴丸组(42例),治疗8周后,观察3组及各组治疗前后血脂、血糖、糖化血红蛋白(Hb A1c)、心肌酶、cox-2、左室射血分数(LVEF)、E峰/A峰变化。结果1与对照组相比,观察组总胆固醇(TC)、总甘油三酯(TG)、低密度脂蛋白胆固醇(LDL)、血糖(FBG、P2h BG)、Hb A1c、心肌酶(CK、CKMB)、cox-2均显著升高,而高密度脂蛋白胆固醇(HDL)、LVEF、E峰/A峰显著下降(P均<0.05);2治疗8周后,与常规治疗相比,银杏叶组、复方丹参滴丸组CK、CKMB、cox-2均明显降低(P均<0.05),银杏叶组降低更加明显(P均<0.01);3与复方丹参滴丸组相比,银杏叶组cox-2显著下降(P<0.05);但CK、CKMB变化不明显(P均>0.05)。4与治疗前相比,银杏叶组及复方丹参滴丸组CK、CKMB、cox-2明显降低(P均<0.05);LVEF、E峰/A峰有升高趋势,但无统计学差异(P均>0.05)。结论银杏叶提取物及复方丹参滴丸对糖尿病心肌病均有治疗作用,但银杏叶提取物治疗效果更优,其cox-2可作为糖尿病心肌改善的早期指标。

Objective：To explore the role of oxidase （cox）-2 role in diabetic cardiomyopathy and to search the best to prevent it. Methods： 120 cases of diabetic patients were selected from outpatient and inpatient wards as control group; and 126 patients with diabetic cardiomyopathy were chosen as observation group, according to different interventions. The observation group were randomly divided into conventional treatment group （40 cases ）, ginkgo biloba group （44 cases）, compound danshen dropping pill group（42 cases）, and 8 weeks after treatment, blood fat, sugar, glycosylated hemoglobin （HbAlc）, myocardial enzyme, cox-2, Left ventricular ejection fraction （LVEF）, E/A peak peak were observed in three groups and each group before and after treatment. Results： Compared with controls, total cholesterol （TC）, triglyceride （TG）, low density lipoprotein （LDL） cholesterol, blood glucose （FBG, P2hBG）, HbAlc, myocardial enzymes （CK, CKMB）, cox-2 were significantly increased, and high density lipoprotein cholesterol （HDL）, LVEF, E peak/A peak decreased oberviously in the observation group（ P 〈 0.05 ）. 2. Eight weeks after treatment, CK, CKMB, cox-2 were significantIy lower in ginkgo biloba, compound danshen dropping pill groups compared with conventional treatment, （ P 〈 0.05 ）, but they all reduced more significantly in Ginkgo bitoba group （ P 〈 0.01 ）. 3. Compared with the compound danshen dropping pill group, cox-2 significantly in ginkgo biloba group obviously decreased （ P 〈 0.05 ） ; but CK, CKMB change were not obvious （P 〉0.05）. 4. Compared with those before treatment, CK, CKMB, cox-2 significantly decreased in biloba and compound danshen dropping pill group（P 〈 0.05） ; and LVEF, E peak/A peak had a rising trend, but there was no statistical difference （P 〉 0.05）. Conclusion ： Both ginkgo biloba extract and compound danshen dropping pill have therapeutic effect on diabetic cardiomyopathy, but the treatment effection of ginkgo biloba extract is better, and cox-2 can be used as early indicator of myocardial improvement in diaetes.