西列汀对2型糖尿病合并心衰患者的降糖及心功能改善作用研究

Effect of Reducing Blood Glucose and Improving Cardiac Function of Sitagliptinon Patients with T2DM Complicated with Heart Failure

目的探讨西格列汀治疗2型糖尿病(T2DM)合并心衰患者的效果及对患者心功能的影响。方法选取我院收集的140例T2DM合并心衰患者,收集时间2016年9月至2017年9月,采用随机数字表法分为研究组和对照组各70例,研究组给予西格列汀+基础抗心衰治疗,对照组给予格列吡嗪+基础抗心衰治疗,对比两组降糖效果及心功能指标变化。结果治疗前,研究组和对照组的FPG、Hb A1c、2Hpg、hs-CRP、TNF-α、IL-6水平差异无统计学意义(P>0. 05);治疗后,研究组的FPG、HbA1c、2hPG、hs-CRP、TNF-α、IL-6水平均低于对照组,两组患者的FPG、Hb A1c、2hPG、hs-CRP、TNF-α、IL-6较治疗前均显著降低,差异有统计学意义(P<0. 05)。治疗前,研究组和对照组的NT-proBNP、LVEF%、LVEDd水平差异无统计学意义(P>0. 05);治疗后,研究组的NT-proBNP、LVEDd水平均低于对照组,LVEF%高于对照组,差异有统计学意义(P<0. 05)。两组患者的NT-proBNP、LVEDd较治疗前均显著的降低,LVEF%较治疗前显著的升高,差异有统计学意义(P<0. 05)。结论西格列汀治疗T2DM合并心衰患者具有较好的降糖效果,同时能改善患者的心功能。

Objective To investigate the effect of sitagliptin on patients with type 2 diabetes mellitus（ T2DM） complicated with heart failure and its effect on cardiac function.Methods 140 cases of T2DM complicated with heart failure received in our hospital between September 2016 and September 2017 were included and randomly divided in to study group and control group,70 cases for each,according to random number table. Patients in the study group were administrated sitagliptin and routine anti-heart failure treatment,while patients in the control group were administrated glipizide and routine anti-heart failure treatment. Hypoglycemic effect and changes of cardiac function indicators of the two groups were compared. Results Before treatment,there was no statistically significant difference in FPG,HbA1c,2 hPG,hs-CRP,TNF-α,and IL-6 levels between the two groups（ P〉0. 05）. After treatment,FPG,HbA1c,2 hPG,hs-CRP,TNF-α,and IL-6 levels of study group were all lower than those of control group,and FPG,HbA1c,2 hPG,hs-CRP,TNF-α,and IL-6 levels of both groups acquired a significant reduction when compared with those before treatment,the differences being statistically significant（ P〈0. 05）. Before treatment,there was no statistically significant difference in the levels of NT-proBNP,LVEF% and LVEDd between the two groups（ P〉0. 05）. After treatment,the levels of NT-proBNP and LVEDd in the study group were lower than those in the control group（ P 〈 0. 05）,while LVEF% of the study group was higher than that of the control group,with statistically significant differences（ P〈0. 05）. NT-proBNP and LVEDd of both two groups acquired significant reduction and LVEF% acquired significant increase when compared with those before treatment,the differences being statistically significant（ P〈0. 05）. Conclusion Sitagliptin,in the treatment of T2DM patients complicated with heart failure,has favorable hypoglycemic effect and can improve cardiac function of patients simultaneously.