利拉鲁肽注射液联合瑞舒伐他汀钙片治疗对老年慢性共病患者脂肪细胞因子及血脂的影响

Effect of linaglutide injection combined with rosuvastatin calcium tablets on adipocytokines and blood lipids in elderly patients with chronic comorbidity

目的观察利拉鲁肽注射液联合瑞舒伐他汀钙片治疗对老年慢性共病患者脂肪细胞因子及血脂的影响。方法前瞻性选取2022年1月至2022年10月河北大学附属医院收治的120例老年慢性共病患者作为研究对象,采用信封随机法将其分为对照组(n=57)和观察组(n=63)。两组患者均进行老年综合评估,并在其指导下应用降压、调脂、降糖等药物,对照组给予二甲双胍联合瑞舒伐他汀钙片治疗,观察组给予利拉鲁肽注射液联合瑞舒伐他汀钙片治疗。比较治疗前和治疗3个月后两组患者的血压、血脂[总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、糖代谢[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)]、脂肪细胞因子[内脏脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)、摄食抑制因子1(Nesfatin-1)、脂联素]水平的差异,统计两组并发症发生率。结果治疗3个月后,两组收缩压、舒张压、总胆固醇、甘油三酯、LDL-C水平均较治疗前明显下降,且观察组治疗3个月后收缩压、舒张压、总胆固醇、甘油三酯、LDL-C水平分别为(124.44±5.27)mmHg、(76.23±2.11)mmHg、(4.08±0.84)mmol/L、(1.24±0.32)mmol/L、(3.11±0.32)mmol/L,均低于对照组[(127.05±8.52)mmHg、(77.45±2.74)mmHg、(4.85±0.92)mmol/L、(1.74±0.44)mmol/L、(3.67±0.37)mmol/L],HDL-C水平为(1.54±0.41)mmol/L,高于对照组[(1.33±0.37)mmol/L],差异均有统计学意义(P<0.05)。治疗3个月后,两组FBG、2 h PBG、HbA1c、Vaspin、Nesfatin-1水平均较治疗前明显下降,脂联素较治疗前明显升高,且观察组治疗3个月后FBG、2 h PBG、HbA1c、Vaspin、Nesfatin-1水平分别为(6.07±1.14)mmol/L、(9.03±1.74)mmol/L、(6.67±1.67)%、(3.47±0.92)μg/mL、(1.31±0.33)ng/mL,均低于对照组[(6.86±1.54)mmol/L、(10.25±2.07)mmol/L、(7.55±2.14)%、(4.24±1.05)μg/mL、(1.74±0.42)ng/mL],脂联素为(19.77±2.14)μg/mL,高于对照组[(16.58±2.03)μg/mL],差异均有统计学意义(P<0.05)。观察组脑出血、急性心肌梗死、心力衰竭等并发症发生率为4.76%,低于对照组(15.79%),差异有统计学意义(P<0.05)。结论利拉鲁肽注射液联合瑞舒伐他汀钙片治疗老年慢性共病可有效控制患者血压,调节糖脂代谢,减少心脑血管病的发生。

Objective To observe the effect of linaglutide injection combined with rosuvastatin calcium tablets on adipocytokines and blood lipids in elderly patients with chronic comorbidity.Methods A prospective study was conducted on 120 elderly patients with chronic comorbidities admitted to the Affiliated Hospital of Hebei University from January 2022 to October 2022.The patients were randomly divided into a control group(n=57)and an observation group(n=63)using the envelope randomization method.The patients in both groups were comprehensively evaluated for their old age,and under their guidance,they were treated with antihypertensive,lipid-lowering,hypoglycemic and other drugs.The control group was treated with metformin combined with rosuvastatin calcium tablets,and the observation group was treated with linaglutide injection combined with rosuvastatin calcium tablets.The levels of blood pressure,blood lipids[total cholesterol,triglycerides,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],glucose metabolism[fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),hemoglobin A1c(HbA1c)],adipocytokines[visceral fat specific serine protease inhibitor(Vaspin),Nesfatin-1,adiponectin]before 3 months after treatment between the two groups were compared,and the incidence of complications of the two groups were counted.Results After 3 months of treatment,the levels of systolic blood pressure,diastolic blood pressure,total cholesterol,triglycerides,and LDL-C of the two groups were significantly decreased compared with those before treatment,and the observation group were(124.44±5.27)mmHg,(76.23±2.11)mmHg,(4.08±0.84)mmol/L,(1.24±0.32)mmol/L,and(3.11±0.32)mmol/L,respectively,which were lower than those in the control group[(127.05±8.52)mmHg,(77.45±2.74)mmHg,(4.85±0.92)mmol/L,(1.74±0.44)mmol/L,(3.67±0.37)mmol/L],the HDL-C level was(1.54±0.41)mmol/L,which was higher than the control group[(1.33±0.37)mmol/L],the differences were statistically significant(P<0.05).After 3 months of treatment,the levels of FBG,2 h PBG,HbA1c,Vaspin,and Nesfatin-1 in both groups decreased significantly compared with those before treatment,while adiponectin increased significantly,moreover,the levels of FBG,2 h PBG,HbA1c,Vaspin,and Nesfatin-1 in the observation group were(6.07±1.14)mmol/L,(9.03±1.74)mmol/L,(6.67±1.67)%,(3.47±0.92)μg/mL,(1.31±0.33)ng/mL,respectively,which were lower than those in the control group[(6.86±1.54)mmol/L,(10.25±2.07)mmol/L,(7.55±2.14)%,(4.24±1.05)μg/mL,(1.74±0.42)ng/mL],adiponectin was(19.77±2.14)μg/mL,which was higher than the control group[(16.58±2.03)μg/mL],the differences were statistically significant(P<0.05).The incidence of cerebral hemorrhage,acute myocardial infarction,heart failure and other complications in the observation group was 4.76%,which was lower than that in the control group(15.79%),the difference was statistically significant(P<0.05).Conclusion Lilalutide injection combined with rosuvastatin calcium tablets can effectively control blood pressure,regulate glucose and lipid metabolism,and reduce the incidence of cardiovascular and cerebrovascular diseases in elderly patients with chronic comorbidities.