磷酸西格列汀与二甲双胍联合治疗2型糖尿病并心衰的效果及对血清炎性因子的影响

Effect of Sitagliptin Phosphate and Metformin in the Treatment of Type 2 Diabetes Complicated with Heart Failure and Its Influence on Serum Inflammatory Factors

目的探讨磷酸西格列汀与二甲双胍联合治疗2型糖尿病并心衰的效果及对血清炎性因子的影响。方法150例研究对象均为2018年11月—2020年10月期间该院收治的2型糖尿病并心衰患者,以随机数字表法划分为两组。两组患者采用常规抗心衰药物治疗、口服二甲双胍和皮下注射胰岛素治疗,研究组在此基础上联合早餐后口服磷酸西格列汀片。在治疗前与治疗后,比较两组血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)]、心功能指标[左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、心率(HR)]、炎症因子[白细胞介素(IL-6)、C反应蛋白(CRP)与肿瘤坏死因子α(TNF-α)]以及两组治疗期间的不良反应情况。结果治疗后,研究组FPG、2 hPG、HbA1c水平较对照组更低,差异有统计学意义(P<0.01),研究组LVEF较对照组更高,差异有统计学意义(P<0.01),HR水平较对照组更低,差异有统计学意义(P<0.01),研究组IL-6、CRP与TNF-α水平较对照组更低,差异有统计学意义(P<0.01),研究组不良反应发生率2.67%与对照组2.67%对比,差异无统计学意义(P>0.05)。结论磷酸西格列汀与二甲双胍联合治疗2型糖尿病并心衰效果确切,适于临床推广。

Objective To investigate the effect of sitagliptin phosphate combined with metformin in the treatment of type 2 diabetes with heart failure and its influence on serum inflammatory factors.Methods 150 study subjects were all patients with type 2 diabetes and heart failure admitted to the hospital from November 2018 to October 2020.They were divided into two groups by random number table.Two groups of patients were treated with conventional anti-heart failure drugs,received treatment of oral metformin and subcutaneous injection of insulin.On this basis,the study group received sitagliptin phosphate tablets after breakfast.Before and after treatment,compared the two groups of blood glucose indicators[fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 hPG),glycosylated hemoglobin(HbA1c)],cardiac function indicators[left ventricular end diastolic diameter(LVEDD),left ventricular ejaculation blood fraction(LVEF),heart rate(HR)],inflammatory factors[interleukin(IL-6),C-reactive protein(CRP)and tumor necrosis factorα(TNF-α)]and adversed reactions during treatment in the two groups.Results After treatment,the levels of FPG,2 hPG,and HbA1c in the study group were lower than those in the control group.The difference was statistically significant(P<0.01),the LVEF in the study group was higher than the control group,the difference was statistically significant(P<0.01),and the HR level was lower than the control group,the difference was statistically significant(P<0.01);the levels of IL-6,CRP and TNF-α in the study group were lower than those in the control group,the difference was statistically significant(P<0.01),and the incidence of adverse reactions in the study group was 2.67%,compared with 2.67% in the control group,the was no statistically significantdifference(P>0.05).Conclusion The combination of sitagliptin phosphate and metformin in the treatment of type 2 diabetes with heart failure is effective and suitable for clinical promotion.