西格列汀对2型糖尿病患者颈动脉内膜中层厚度的影响

Influence of sitagliptin to carotid intima-media thickness of patients with type 2 diabetes

目的 观察西格列汀对2型糖尿病患者颈动脉内膜中层厚度的影响及其可能机制。方法 选取我院2013年1月~2016年1月收治入院的70例2型糖尿病患者随机分为实验组和对照组各35例。实验组给予磷酸西格列汀和格华止口服,共24周,对照组给予阿卡波糖和格华止口服,共24周。测定治疗前后患者空腹血糖（FGP）、餐后2h血糖（2h PG）、糖化血红蛋白（GHb A1C）及颈动脉内膜中层厚度（IMT）。结果 两组治疗前血糖、餐后2h血糖、糖化血红蛋白及胰岛素用量、颈动脉内膜中层厚度等结果比较差异无统计学意义（P〉0.05）;治疗后血糖、餐后2h血糖、糖化血红蛋白及胰岛素用量、颈动脉内膜中层厚度等结果均较治疗前和对照组治疗后比较差异有统计学意义（P〈0.05）;两组治疗前BMI、总胆固醇、甘油三酯、高密度脂蛋白及低密度脂蛋白结果比较差异无统计学意义（P〉0.05）;治疗后BMI、总胆固醇及低密度脂蛋白结果比较差异有统计学意义（P〈0.05）。结论 西格列汀除有效降低患者血糖外,还可改善或阻止动脉粥样硬化。

Objective To observe the influence and its possible mechanism of sitagliptin to carotid intima-media thickness of patients with type 2 diabetes. Methods 70 cases of patients with type 2 diabetes cured in our hospital from January 2013 to January 2016 were selected and randomly divided into experiment group and control group with 35 cases in each. Patients in experiment group were treated with sitagliptin phosphate and metformin oral for 24 weeks, and patients in control group were treated with acarbose and metformin oral for 24 weeks. Fasting plasma glucose （FGP）, 2h postprandial blood glucose （2hPG）, glycated hemoglobin （GHbA1C） and carotid intima-media thickness （IMT） of the patients before and after the treatment were determined. Results There were no significant differences on fasting plasma glucose （FGP）, 2h postprandial blood glucose （2Hpg）, glycated hemoglobin, insulin dosage, carotid intima-media thickness and other results of the two groups before the treatment （P 〉 0.05）. After the treatment, fasting plasma glucose, 2h postprandial blood glucose, glycated hemoglobin, insulin dosage, carotid intima- media thickness and other results of the two groups were all different with those before the treatment and those of control group after the treatment（P 〈 0.05）. There were no significant differences on the comparison results of BMI, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein of the two groups before the treatment （P 〉 0.05）.There were some differences on the comparison results of BMI, , total cholesterol, Low-density lipoprotein after the treatment（P 〈 0.05）. Conclusion Sitagliptin can effectively reduce blood sugar, and also can improve or prevent atherosclerosis.