达格列净和维格列汀对老年糖尿病并冠心病患者VEGF、ET-1、NO的影响

Effects of Dapagliflozin and Vildagliptin on VEGF,ET-1 and NO in Elderly Patients with Diabetes Mellitus and Coronary Artery Disease

目的评估达格列净、维格列汀应用在老年糖尿病(diabetes mellitus,DM)并冠心病(coronary heart dis‐ease,CHD)患者中的效果及对血管内皮生长因子(vascular endothelial growth factor,VEGF)、内皮素-1(endo‐thelin-1,ET-1)、一氧化氮(nitric oxide,NO)的影响。方法纳入2021年1月—2022年6月平原县中医院收治的102例老年DM并CHD患者,参照随机数表法划分A组(51例,行达格列净治疗)、B组(51例,行维格列汀治疗),评价组间治疗有效率、VEGF、ET-1、NO、左心室射血分数(left ventricular ejection fraction,LVEF)、餐后2 h血糖(2-h postprandial glucose,2 hPG)、空腹血糖(fasting glucose,FPG)、药物不良反应(adverse drug reac‐tions,ADR)等临床指标。结果A组治疗有效率及ADR与B组比较,差异无统计学意义(χ^(2)=0.793、0.000,P>0.05);治疗3个月后,A组VEGF、ET-1、2 hPG、FPG更低,NO、LVEF更高,差异有统计学意义(P<0.05)。结论达格列净、维格列汀在治疗老年DM并CHD患者时疗效、不良反应基本相当,但是前者在改善心功能及血管内皮功能、降低血糖方面更具优势。

Objective To evaluate the effects of Dapagliflozin and vildagliptin in elderly patients with diabetes mellitus(DM)and coronary heart disease(CHD)and the effects on vascular endothelial growth factor(VEGF),endothelin-1(ET-1)and nitric oxide(NO).Methods One hundred and two elderly patients with DM and CHD admitted to Pingyuan Hospital of Traditional Chinese Medicine from January 2021 to June 2022 were included.Group A(51 patients treated with Dapagliflozin)and group B(51 patients treated with vildagliptin)were divided according to the random number table method,and clinical indexes such as treatment efficiency,VEGF,ET-1,NO,left ventricular ejection fraction(LVEF),2-h postprandial glucose(2 hPG),fasting glucose(FPG),and adverse drug reactions(ADR)were evaluated between groups.Results The effective rate and ADR of group A were compared with group B,there was no statistically significant difference(χ^(2)=0.793,0.153,P>0.05).After 3 months of treatment,VEGF,ET-1,2 hPG and FPG were lower in group A,while NO and LVEF were higher,the difference was statistically significant(P<0.05).Conclusion The efficacy and adverse effects of Dapagliflozin and vildagliptin are basically comparable in the treatment of elderly patients with DM and CHD,but the former has more advantages in improving cardiac function and vascular endothelial function and lowering blood glucose.