血脂康联合利拉鲁肽与二甲双胍对糖尿病并发冠心病的疗效

Therapeutic effect of Xuezhikang combined liraglutide and metformin on DM+CHD patients

目的:研究血脂康联合利拉鲁肽与二甲双胍对糖尿病并发冠心病(DM+CHD)的疗效。方法:2018年2月~2019年1月于我院治疗的134例DM+CHD患者被随机均分为二甲双胍联合利拉鲁肽(对照组)和血脂康联合组(在对照组基础上增加血脂康),观察比较两组治疗前、3个月后的相关指标水平。结果:与对照组比较,血脂康联合组治疗后FPG[(6.55±1.55)mmol/L比(6.08±1.43)mmol/L]、2hPG[(8.57±1.34)mmol/L比(7.97±1.28)mmol/L]、HbA1c[(6.51±1.08)%比(6.09±1.03)%]、TG[(2.26±0.64)mmol/L比(1.76±0.47)mmol/L]、TC[(5.10±1.11)mmol/L比(4.07±0.92)mmol/L]、LDL-C[(2.77±0.80)mmol/L比(2.29±0.68)mmol/L]水平、全血高切黏度[(4.54±0.99)mPa·s比(3.47±0.85)mPa·s]、全血低切黏度[(8.78±1.49)mPa·s比(7.29±1.41)mPa·s]、血浆黏度[(1.81±0.25)mPa·s比(1.58±0.20)mPa·s]、血浆纤维蛋白原水平[(2.85±0.69)g/L比(2.51±0.56)g/L]、血清IL-6[(10.22±2.01)ng/L比(7.56±1.76)ng/L]、TNF-α[(15.90±5.04)ng/L比(11.80±4.99)ng/L]、hsCRP[(6.88±1.72)mg/L比(5.30±1.43)mg/L]、ET-1[(68.78±13.86)ng/L比(59.43±12.80)ng/L]、VEC[(4.01±1.16)ng/ml比(3.41±1.01)ng/ml]水平、LVPWT[(11.57±1.38)mm比(10.11±1.16)mm]、LVESd[(36.53±4.09)mm比(31.67±3.92)mm]、LVEDd[(52.22±4.32)mm比(46.65±4.23)mm]降低更显著,HDL-C水平[(1.38±0.44)mmol/L比(1.62±0.52)mmol/L]、血清NO水平[(52.42±8.20)μmol/L比(59.73±9.26)μmol/L]、LVEF[(53.33±4.87)%比(57.95±5.19)%]升高更显著(P<0.05或<0.01)。两组不良反应率无显著差异(P=0.710)。结论:血脂康联合利拉鲁肽与二甲双胍能更显著改善DM+CHD患者的血糖、血脂、炎性因子水平,血液流变学指标,血管内皮功能及心功能,安全性好。

Objective:To study therapeutic effect of Xuezhikang combined liraglutide and metformin on patients with diabetes mellitus complicated coronary heart disease(DM+CHD).Methods:A total of 134 DM+CHD patients treated in our hospital from Feb 2018 to Jan 2019 was randomly and equally divided into liraglutide combine metformin group(control group)and Xuezhikang combined group(received Xuezhikang on the basis of the control group).Related index levels were observed and compared between two groups before and three months after treatment.Results:Compared with control group,after treatment,there was significant reductions in levels of FBG[(6.55±1.55)mmol/L vs.(6.08±1.43)mmol/L],2hPG[(8.57±1.34)mmol/L vs.(7.97±1.28)mmol/L],HbA1c[(6.51±1.08)%vs.(6.09±1.03)%],TG[(2.26±0.64)mmol/L vs.(1.76±0.47)mmol/L],TC[(5.10±1.11)mmol/L vs.(4.07±0.92)mmol/L]and LDL-C[(2.77±0.80)mmol/L vs.(2.29±0.68)mmol/L],whole blood high shear viscosity[(4.54±0.99)mPa·s vs.(3.47±0.85)mPa·s],whole blood low shear viscosity[(8.78±1.49)mPa·s vs.(7.29±1.41)mPa·s],plasma viscosity[(1.81±0.25)mPa·s vs.(1.58±0.20)mPa·s],plasma fibrinogen level[(2.85±0.69)g/L vs.(2.51±0.56)g/L],serum levels of IL-6[(10.22±2.01)ng/L vs.(7.56±1.76)ng/L],TNF-α[(15.90±5.04)ng/L vs.(11.80±4.99)ng/L],hsCRP[(6.88±1.72)mg/L vs.(5.30±1.43)mg/L],ET-1[(68.78±13.86)ng/L vs.(59.43±12.80)ng/L]and VEC[(4.01±1.16)ng/ml vs.(3.41±1.01)ng/ml],LVPWT[(11.59±1.38)mm vs.(10.11±1.16)mm],LVESd[(36.53±4.09)mm vs.(31.67±3.92)mm]and LVEDd[(51.22±4.72)mm vs.(46.25±4.53)mm],and significant rise in levels of HDL-C[(1.38±0.44)mmol/L vs.(1.62±0.52)mmol/L],serum NO level[(52.42±8.20)μmol/L vs.(59.73±9.26)μmol/L]and LVEF[(53.33±4.87)%vs.(57.95±5.19)%]in Xuezhikang combined group(P<0.05 or<0.01).There was on significant difference in incidence of adverse reactions between two groups(P=0.710).Conclusion:Xuezhikang combined liraglutide and metformin can more significantly improve levels of blood glucose,blood lipids and inflammatory factor,hemorheological indexes,vascular endothelial function and cardiac function with good safety in DM+CHD patients.