缬沙坦联合他汀类治疗糖尿病伴冠心病患者疗效及其对PPAR-γ的影响

Effects of valsartan combined with statins on blood glucose,blood lipids,HGF and PPAR-γ in patients with diabetes and coronary heart disease

目的探究缬沙坦联合他汀类治疗对糖尿病伴冠心病患者血糖、血脂及肝细胞生长因子(HGF)、过氧化物酶体增殖剂激活受体(PPAR-γ)的影响。方法选择2015年2月—2017年2月江苏省常熟市第二人民医院内分泌科诊治的糖尿病伴冠心病患者90例作为研究对象,按照随机数字表法分为2组各45例。对照组患者以缬沙坦治疗,观察组在对照组基础上联合瑞舒伐他汀治疗。治疗4个月后,检测患者治疗前后的血糖、血脂、HGF以及PPAR-γ水平变化。结果治疗前后2组患者的FPG以及2hPG比较无显著差异(P>0.05)。治疗前血脂(TC、TG、LDL-C、HDL-C)比较差异无统计学意义(P>0.05),治疗后2组均改善,且观察组TC、TG、LDL-C低于对照组(t=6.365,P=0.000;t=6.354,P=0.000;t=6.225,P=0.000),HDL-C高于对照组(t=6.465,P=0.000),治疗前2组HGF、PPAR-γ水平比较差异无统计学意义(P>0.05),治疗后2组均改善且观察组HGF水平低于对照组,PPAR-γ高于对照组(t=7.274=0.000;t=11.457,P=0.000)。结论缬沙坦联合他汀类药物通过调节PPAR-γ从而更有效地调节糖尿病伴冠心病患者的血脂、血糖水平,改善HGF和PPAR-γ水平。

Objective To investigate the effect of valsartan combined with statin on blood glucose,blood lipid,HGF and PPAR-γ in patients with coronary heart disease. Methods Ninety patients with coronary disease and diabetes were chose from February 2015 to February 2017. According to the digital random table method, they were divided into two groups. Patients in the control group were treated with valsartan. Patients in the observation group were treated with rosuvastatin on the basis of the control group. The effect of blood glucose, blood lipid, HGF and PPAR-γ levels in each group before and after treatment were detected. Results There were no significant differences in FPG and 2 hPG between the two groups before treatment（t =1.734. P = 0. 163; t = 1. 832, P = 0. 279; t = 1.453, P = 0.108; t = 1. 143, P = 0. 124）. There was no significant difference in the blood lipid levels between the two groups before treatment（P〉0. 05）. After treatment, the blood lipid levels of both groups were significantly improved（ P〈0. 05）. The levels of TC, TG and LDL-C in the observation group were significantly lower than those in the control group（t =6. 365, P = 0. 000; t = 6. 354, P = 0. 000; t = 6. 225, P = 0. 000）. HDL-C in the observation group was significantly higher than that in the control group（t = 6. 465, P = 0. 000）. There was no significant difference in HGF and PPAR-γ levels between the two groups before treatment（t = 0. 745, P = 0. 276; t = 0. 257, P =0.740）. After treatment, the two indexes in both groups were significantly improved（P〈0.05）. After treatment,the levels of HGF in the observation group were significantly lower than that in the control group, and PPAR-γ level was significantly higher than that in the control group（t =7. 274, P = 0. 000; t= 11.457, P = 0. 000）. Conclusion Combination with valsartan and statins, lipid levels in patients with diabetes and coronary heart disease are more effectively regulated by PPAR-γ.