硫辛酸联合阿司匹林对2型糖尿病合并大血管病变患者血糖控制及炎性因子水平变化的影响

Effects of lipoic acid combined with aspirin on blood glucose and inflammatory factors in patients with type 2 diabetes mellitus complicated with macrovascular disease

目的探讨硫辛酸联合阿司匹林对2型糖尿病合并大血管病变患者血糖控制及高敏C反应蛋白（hs-CRP）和白细胞介素6（IL-6）水平变化的影响。方法选取2014年12月至2016年12月于西安市中心医院治疗的2型糖尿病合并大血管病变患者76例。根据随机数字表法将患者分为对照组和观察组，各38例。对照组给予常规治疗；观察组在对照组基础上给予静脉注射硫辛酸和口服阿司匹林肠溶片。2组均治疗1个月。比较2组血糖（空腹血糖、餐后2 h血糖）、血脂［三酰甘油、总胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）］、hs-CRP和IL-6水平及不良反应发生情况。结果治疗前,2组空腹血糖、餐后2 h血糖、LDL-C、总胆固醇、三酰甘油、HDL-C、hs-CRP和IL-6水平比较,差异均无统计学意义（均P〉0.05）。治疗后,2组空腹血糖、餐后2 h血糖、LDL-C、总胆固醇、三酰甘油、hs-CRP和IL-6水平低于治疗前，HDL-C水平高于治疗前［观察组：（8.5±1.2）mmol/L比（9.9±1.2）mmol/L、（8.60±1.02）mmol/L比（10.02±1.21）mmol/L、（2.44±0.16）mmol/L比（3.05±0.28）mmol/L、（5.3±0.6）mmol/L比（6.1±1.0）mmol/L、（2.0±0.6）mmol/L比（2.6±1.3）mmol/L、（2.4±1.1）mg/L比（7.3±1.7）mg/L、（7±3）ng/L比（13±6）ng/L、（1.68±0.13）mmol/L比（1.35±0.27）mmol/L；对照组：（9.8±1.5）mmol/L比（10.0±1.0）mmol/L、（9.72±1.52）mmol/L比（10.06±0.07）mmol/L、（2.90±0.23）mmol/L比（3.08±0.30）mmol/L、（5.8±0.9）mmol/L比（6.0±1.1）mmol/L、（2.4±1.4）mmol/L比（2.5±1.6）mmol/L、（4.7±1.6）mg/L比（7.3±1.6）mg/L、（11±6）ng/L比（13±6）ng/L、（1.45±0.18）mmol/L比（1.34±0.25）mmol/L］，且观察组空腹血糖、餐后2 h血糖、LDL-C、总胆固醇、三酰甘油、hs-CRP和IL-6水平低于而HDL-C水平高于对照组，差异均有统计学意义（均P＜0.05）。观察组不良反应发生率与对照组比较，差异无统计学意义（P＞0.05）。结论硫辛酸联合阿司匹林治疗2型糖尿病合并大血管病变患者可有效控制血糖水平，降低血脂、hs-CRP及IL-6水平，且安全性较高。

ObjectiveTo investigate effects of lipoic acid combined with aspirin on blood glucose, high-sensitivity C-reactive protein（hs-CRP） and interleukin-6（IL-6） in patients with type 2 diabetes mellitus complicated with macrovascular diseases. MethodsTotally 76 cases of type 2 diabetic patients with macrovascular diseases from December 2014 to December 2016 in Xi′an Central Hospital were randomly divided into control group and observation group, with 38 cases in each group. The control group had conventional therapy; the observation group was treated with lipoic acid intravenous injection and aspirin based on control group; both groups were treated for 1 month. Levels of blood glucose[fasting blood glucose（FBG） and 2 h postprandial blood glucose（2 h BG）], blood lipid[triacylglycerol（TG）, total cholesterol（TC）, low-density lipoprotein cholesterin（LDL-C）, high-density lipoprotein cholesterin（HDL-C）], hs-CRP, IL-6 and incidence of adverse reactions were analyzed. ResultsThere were no significant differences of FBG, 2 h BG, TG, TC, LDL-C, HDL-C, hs-CRP and IL-6 between groups before treatment（P〉0.05）. Levels of FBG, 2 h BG, TG, TC, LDL-C, hs-CRP and IL-6 after treatment were significantly lower and the level of HDL-C was significantly higher than those before treatment in both groups[observation group： （8.5±1.2）mmol/L vs （9.9±1.2）mmol/L, （8.60±1.02）mmol/L vs （10.02±1.21）mmol/L, （2.44±0.16）mmol/L vs （3.05±0.28）mmol/L, （5.3±0.6）mmol/L vs （6.1±1.0）mmol/L, （2.0±0.6）mmol/L vs （2.6±1.3）mmol/L, （2.4±1.1）mg/L vs （7.3±1.7）mg/L, （7±3）ng/L vs （13±6）ng/L, （1.68±0.13）mmol/L vs （1.35±0.27）mmol/L; control group： （9.8±1.5）mmol/L vs （10.0±1.0）mmol/L, （9.72±1.52）mmol/L vs （10.06±0.07）mmol/L, （2.90±0.23）mmol/L vs （3.08±0.30）mmol/L, （5.8±0.9）mmol/L vs （6.0±1.1）mmol/L, （2.4±1.4）mmol/L vs （2.5±1.6）mmol/L, （4.7±1.6）mg/L vs （7.3±1.6）mg/L, （11±6）ng/L vs （13±6）ng/L, （1.45±0.18）mmol/L vs （1.34±0.25）mmol/L]（P〈0.05）; there were also significant differences of above indicators between groups after treatment（P〈0.05）. The incidence of adverse reactions had no significant difference between groups（P〉0.05）. ConclusionLipoic acid combined with aspirin can safely and effectively control blood glucose and lipid, decrease levels of hs-CRP and IL-6 in type 2 diabetic patients with macrovascular diseases.