二甲双胍联合双歧杆菌三联活菌胶囊对老年糖尿病合并动脉粥样硬化患者血脂、颈动脉斑块和肠道菌群的影响

The Effect of Metformin Combined with Bifidobacterium Triple Viable Capsules on Blood Lipids,Carotid Plaque and Intestinal Flora in Elderly Diabetic Patients with Atherosclerosis

目的:探讨二甲双胍联合双歧杆菌三联活菌胶囊对老年糖尿病合并动脉粥样硬化患者血脂、颈动脉斑块和肠道菌群的影响。方法:回顾性分析2019年1月至2020年12月期间广州市东升医院收治的120例老年糖尿病合并动脉粥样硬化患者的临床资料,按随机数字表法将患者分为对照组(n=58)和观察组(n=62)。对照组给予二甲双胍治疗,观察组在对照组治疗的基础上给予双歧杆菌三联活菌胶囊治疗。比较两组患者治疗前后三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、颈动脉斑块内膜-中层厚度(IMT)及斑块面积、肠道双歧杆菌、革兰阳性杆菌(G^(+)b)、革兰阴性杆菌(G^(-)b)数量变化情况,观察两组患者治疗期间的不良反应。结果:治疗后观察组TG、TC、LDL-C水平显著低于对照组,颈动脉IMT及斑块面积降低幅度较对照组更显著,肠道双歧杆菌、G^(+)b、G^(-)b等肠道菌群数量显著高于对照组,差异有统计学意义(P<0.05)。治疗期间两组患者均未出现严重不良反应。结论:二甲双胍联合双歧杆菌三联活菌胶囊治疗老年糖尿病合并动脉粥样硬化患者,可改善血脂代谢功能,降低IMT及斑块面积,增加肠道双歧杆菌的数量。

Objective:To explore the effect of metformin combined with bifidobacterium triple viable capsules on blood lipids,carotid plaque and intestinal flora in elderly patients with diabetes and atherosclerosis.Methods:The clinical data of 120 elderly patients with diabetes and atherosclerosis admitted to Guangzhou Dongsheng Hospital from January 2019 to December 2020 were retrospectively analyzed.The patients were divided into control group (n=58) and observation group (n=62) according to the random number table method.The control group was given metformin treatment,and the observation group was given bifidobacterium triple viable capsules treatment on the basis of the control group.Comparison of triacylglycerol (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),carotid plaque intima-media thickness (IMT),plaque area,the changes in the number of bifidobacteria,gram-positive bacilli (G^(+)b),and gram-negative bacilli (G^(-)b) before and after treatment between the two groups were observed.Adverse reactions of the two groups of patients during treatment were observed.Results:After treatment,the levels of TG,TC,and LDL-C in the observation group were significantly lower than those in the control group.The reduction of carotid artery IMT and plaque area was more significant than that of the control group.The number of intestinal floras such as bifidobacteria,G^(+)b,and G^(-)b was significantly higher than that of the control group,and the difference was statistically significant (P<0.05).No serious adverse reactions occurred in the two groups of patients during the treatment.Conclusion:The combination of metformin and bifidobacterium triple viable capsules in the treatment of elderly patients with diabetes and atherosclerosis can improve blood lipid metabolism,reduce IMT and plaque area,and increase the number of intestinal bifidobacteria.