二甲双胍联合GLP-1受体激动剂治疗2型糖尿病合并心血管疾病的药理机制研究

Study on the pharmacological mechanism of metformin combined with GLP-1 receptor agonists in the treatment of type 2diabetes mellitus complicated with cardiovascular disease

目的 探讨研究二甲双胍联合GLP-1受体激动剂治疗2型糖尿病合并心血管疾病的药理机制。方法 选取2021年5月~2022年12月收治并确诊为2型糖尿病合并心血管疾病的患者90例,用随机数字表法分为研究组与对照组,每组各45例。两组患者均给予常规运动及饮食控制干预,对照组患者给予二甲双胍治疗,研究组患者给予二甲双胍联合GLP-1受体激动剂治疗,比较两组患者的心功能、血糖、血脂指标及不良反应的发生情况。结果 治疗后研究组的左室舒张末期内径(LVEDd)指标降低较对照组更为明显,研究组的左室射血分数(LVEF)、舒张早期最大峰值速度/舒张晚期最大峰值速度(E/A)指标高于对照组(P <0.05)。治疗后研究组患者的测糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)指标低于对照组(P <0.05)。治疗后研究组患者甘油三酯(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)指标低于对照组,高密度脂蛋白胆固醇(HDL-C)高于对照组(P <0.05)。研究组不良反应发生率为6.67%,较对照组的13.33%更低,但差异无统计学意义(P> 0.05)。结论 二甲双胍联合GLP-1受体激动剂治疗2型糖尿病合并心血管疾病的临床疗效较好,安全性较高,有效调节患者的血糖血脂水平,改善心功能状态,保护心血管系统,提升患者生存质量。

Objective To investigate the pharmacological mechanism of metformin combined with GLP-1 receptor agonists in the treatment of type 2 diabetes mellitus complicated with cardiovascular disease.Methods Patients diagnosed with type 2 diabetes combined with cardiovascular disease admitted to a hospital from May 2021 to December 2022 were selected by random number table method,and 90 of them were screened,and they were divided into study group and control group,with 45 patients in each group.Both groups were given routine exercise and diet control intervention,while the control group was given metformin treatment,the study group was given metformin combined with GLP-1receptor agonist treatment.Compared the cardiac function indexes,blood glucose indexes,lipid indexes and the occurrence of adverse reactions between the two groups.Results After treatment,the indexes of left ventricular end-diastolic internal diameter(LVEDd) in the study group were significantly lower than those in the control group,and the indexes of left ventricular ejection fraction(LVEF) and maximum peak diastolic velocity at early stage/maximum peak diastolic velocity at late stage(E/A) in the study group were higher than those in the control group(P<0.05).After treatment,the indexes of glycosylated hemoglobin(HbA1c),fasting blood glucose(FPG) and 2 h postmeal blood glucose(2 hPG) in the study group were lower than those in the control group(P<0.05).After treatment,the indexes of triglyceride(TG),total cholesterol(TC) and low density lipoprotein cholesterol(LDL-C) in the study group were lower than those in the control group,and high density lipoprotein cholesterol(HDL-C) was higher than that in the control group(P<0.05).The incidence of adverse reactions in the study group was 6.67%,which was lower than 13.33% in the control group,but there was no statistically significant difference(P>0.05).Conclusion Metformin combined with GLP-1 receptor agonist has good clinical efficacy and high safety in the treatment of type 2 diabetes mellitus complicated with cardiovascular diseases.It can effectively regulate blood glucose and lipid levels in patients,improve cardiac function,protect cardiovascular system and enhance patients' quality of life.