沙格列汀片联合二甲双胍治疗2型糖尿病合并动脉粥样硬化患者的疗效及对炎症反应和氧化应激的影响

Efficacy of saxagliptin tablets combined with metformin in the treatment of type 2 diabetic patients with atherosclerosis and its effect on inflammatory response and oxidative stress

目的:探究沙格列汀片联合二甲双胍治疗2型糖尿病(T2DM)合并动脉粥样硬化患者的临床疗效及对炎症反应和氧化应激的影响。方法:选取187例T2DM合并颈动脉粥样硬化(AS)患者为研究对象,根据临床治疗方案不同分为研究组(n=94)及对照组(n=93)。对照组采用阿司匹林肠溶片+二甲双胍治疗;研究组在对照组基础上增加沙格列汀片治疗,疗程均为24周。比较两组患者治疗前后空腹血糖(FBG)、餐后2 h血糖(PBG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)水平及胰岛素抵抗指数(HOMA-IR);血清白细胞介素-6(IL-6)、IL-10、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、血浆同型半胱氨酸(Hcy)、丙二醛(MDA)水平;颈动脉中层厚度(IMT)、斑块面积及数量;临床疗效及不良反应发生情况。结果:治疗前,两组患者各项指标比较,差异无统计学意义(P>0.05)。治疗后,研究组患者FBG、PBG、HbA1c、TG、TC、LDL-C水平,血清IL-6、hs-CRP、TNF-α、Hcy、MDA水平,IMT、斑块面积、斑块数量及HOMA-IR均低于治疗前及对照组(P<0.05);HDL-C、FINS、血清IL-10高于治疗前及对照组(P<0.05)。研究组患者总有效率高于对照组(P<0.05)。两组患者不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:沙格列汀联合二甲双胍可有效改善T2DM患者糖脂代谢情况,降低血清炎症细胞因子水平,降低氧化应激反应,保护胰岛β细胞功能,缓解病程进展。

Objective:To explore the clinical efficacy of saxagliptin tablets combined with metformin in the treatment of type 2 diabetic patients with atherosclerosis and its effect on inflammatory response and oxidative stress.Methods:A total of 187 patients with type 2 diabetes mellitus(T2DM)complicated with carotid atherosclerosis(AS)were selected as the research objects,and they were divided into study groups(n=94)and the control group(n=93)according to different clinical treatment schemes.The control group was treated with aspirin enteric-coated tablets+metformin,and the study group was treated with saxagliptin tablets on the basis of the control group,the course of treatment was 24 weeks.The fasting blood glucose(FBG),postprandial blood glucose(PBG),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),calculate the insulin resistance index(HOMA-IR),the levels of detect serum interleukin-6(IL-6),Interleukin-10(IL-10)high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factorα(TNF-α),plasma homocysteine(Hcy),malondialdehyde(MDA),Intima-Media Thickness(IMT),plaque area and number,clinical efficacy and adverse reactions were compared between the two groups before and after treatment.Results:Before treatment,there was no significant difference in the indicators between the two groups(P>0.05).After treatment,the levels of FBG,PBG,HbA1c,TG,TC,LDL-C,serum IL-6,hs-CRP,TNF-α,Hcy,MDA levels,IMT,plaque area and number,and HOMA-IR in the study group were lower than those before treatment and control group,HDL-C,FINS,and serum IL-10 were higher than those before treatment and control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:The combination of saxagliptin and metformin can effectively improve the glucose and lipid metabolism in patients with T2DM,reduce the level of serum inflammatory cytokines,reduce oxidative stress,protect the function of isletβcells,and alleviate the progression of the disease.