丹红注射液对糖尿病合并冠心病患者胰岛素抵抗、内皮功能、炎症因子、心血管事件的影响

Effects of Danhong injection on insulin resistance, endothelial function, inflammatoryfactor and cardiovascular events in diabetic patients with coronary heart disease

目的探讨丹红注射液对2型糖尿病(type 2 diabetes mellitus,T2DM)合并冠心病(coronary heart disease,CHD)患者胰岛素抵抗、内皮功能、炎症因子、心血管事件的影响。方法前瞻性选择206例T2DM合并CHD患者,随机分为对照组和研究组,每组103例。对照组采用常规治疗方案,研究组在对照组的基础上联合应用丹红注射液进行治疗。记录2组患者治疗前后胰岛素抵抗[空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(postprandial 2 h plasma glucose,2 hPG)、糖化血红蛋白(hemoglobin A 1c,HbA 1c)、胰岛素抵抗指数(Homeostasis model assessment insulin resistance,HOMA-IR)]、内皮功能[血流介导的血管内皮依赖性舒张功能(flow-mediated endothelium-dependent vasodilation,FMD)、硝酸甘油介导的非依赖性血管内皮舒张功能(nitroglycerin-mediated non-dependent vasodilation,NMD)]、炎症因子[肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素6(interleukin-6,IL-6)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、调控因子核因子κB(nuclear factor-κB,NF-κB)]、心血管事件的差异。结果与对照组比较,研究组治疗后FPG、2 hPG、HbA 1c、HOMA-IR、TNF-α、IL-6、hs-CRP、NF-κB水平更低(P<0.01),FMD、NMD水平更高(P<0.05或P<0.01)。所有患者均获得6个月随访,随访期间研究组心血管事件发生率低于对照组(P<0.05)。结论丹红注射液可降低T2DM合并CHD患者胰岛素抵抗和炎症反应水平,改善血管内皮功能,预防心血管事件的发生。

Objective To investigate the effects of Danhong injection on insulin resistance,endothelial function,inflammatory factors and cardiovascular events in patients with type 2 diabetes mellitus(T2DM)and coronary heart disease(CHD).Methods Two hundred and six patients with T2DM and CHD were prospectively selected and randomly divided into two groups,103 cases in each group.The control group was treated with routine treatment,while the study group was treated with Danhong injection on the basis of the control group.The differences of insulin resistance[fasting plasma glucose(FPG),postprandial 2 h plasma glucose(2 hPG),hemoglobin A 1c(HbA 1c),Homeostasis model assessment insulin resistance index(HOMA-IR)],endothelial function[flow-mediated endothelium-dependent vasodilation(FMD)and nitroglycerin-mediated non-dependent vasodilation(NMD)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),nuclear factor-κB(NF-κB)]and cardiovascular events between two groups before and after treatment were recorded.Results Compared with the control group,the levels of FPG,2 hPG,HbA 1c,HOMA-IR,TNF-a,IL-6,hs-CRP and NF-κB in the study group were lower(P<0.01),while the levels of FMD and NMD were higher(P<0.05 or P<0.01).All patients were followed up for 6 months.During the follow-up period,the incidence of cardiovascular events in the study group was lower than that in the control group(P<0.05).Conclusion Danhong injection can reduce insulin resistance and inflammation in patients with T2DM and CHD,improve vascular endothelial function and prevent cardiovascular events.