利拉鲁肽联合替格瑞洛对老年2型糖尿病伴冠心病患者的临床疗效观察

Clinical Efficacy Observation of Liraglutide Combined with Ticagrelor in the Treatment of Elderly Type 2 Diabetes Mellitus Patients with Coronary Heart Disease

目的:探讨利拉鲁肽联合替格瑞洛对老年2型糖尿病(T_(2)DM)伴冠心病(CHD)患者的影响。方法:选取2020年1月—2021年1月武汉中西医结合骨科医院收治的70例老年T_(2)DM伴CHD患者为研究对象,按随机数字表法分为对照组(n=35)和研究组(n=35),对照组给予盐酸二甲双胍及替格瑞洛治疗,研究组给予利拉鲁肽联合替格瑞洛治疗,比较两组干预前后的血糖指标[空腹血糖(FPG)、糖化血红蛋白(HbA1c)]、心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、舒张早期二尖瓣血流速度/舒张晚期二尖瓣血流速度(E/A)]、炎症指标[白细胞介素-6(IL-6)、内皮素-1(ET-1)、肿瘤坏死因子-α(TNF-α)]、血管内皮细胞相关因子[血管脂肪抑制素(Vaspin)、生长激素释放肽(Ghrelin)及一氧化氮(NO)]。结果:干预前,两组血糖指标、心功能指标、炎症指标、血管内皮细胞相关因子比较,差异均无统计学意义(P>0.05)。干预后,研究组FPG、HbA1c水平均低于对照组,差异均有统计学意义(P<0.05);干预后,研究组LVEF、E/A均高于对照组,LVEDD低于对照组,差异均有统计学意义(P<0.05);干预后,研究组IL-6、ET-1、TNF-α水平均低于对照组,差异均有统计学意义(P<0.05);干预后,研究组Vaspin、Ghrelin、NO水平均高于对照组,差异均有统计学意义(P<0.05)。结论:老年T_(2)DM伴CHD患者应用利拉鲁肽联合替格瑞洛进行治疗,能有效改善血糖水平、心功能及血管内皮功能,减轻炎症反应。

Objective:To investigate the effect of Liraglutide combined with Ticagrelor on elderly patients with type 2 diabetes mellitus(T_(2)DM)and coronary heart disease(CHD).Method:A total of 70 elderly patients with T_(2)DM and CHD admitted to Wuhan Integrated Traditional Chinese and Western Medicine Orthopedic Hospital from January 2020 to January 2021 were selected as the study objects.They were divided into control group(n=35)and study group(n=35)according to random number table method.The control group was given Metformin Hydrochloride and Ticagrelor,and the study group was given Liraglutide combined with Ticagrelor.Blood glucose indexes[fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c)],cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),early diastolic mitral valve flow velocity/late diastolic mitral valve flow velocity(E/A)],inflammation indexes[interleukin-6(IL-6),endothelin-1(ET-1),tumor necrosis factor-α(TNF-α)],vascular endothelial cell related factors[vascular lipostatin(Vaspin),growth hormone releasing peptide(Ghrelin)and nitric oxide(NO)]between the two groups before and after intervention were compared.Result:Before intervention,there were no significant differences in blood glucose indexes,cardiac function indexes,inflammation indexes and vascular endothelial cell related factors between the two groups(P>0.05).After intervention,the levels of FPG and HbA1c in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).After intervention,LVEF,E/A in the study group were higher than those in the control group,and LVEDD was lower than that in the control group,the differences were statistically significant(P<0.05).After intervention,the levels of IL-6,ET-1 and TNF-αin the study group were lower than those in the control group,the differences were statistically significant(P<0.05).After intervention,the levels of Vaspin,Ghrelin and NO in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Liraglutide combined with Ticagrelor can effectively improve blood glucose level,cardiac function and vascular endothelial function,and reduce inflammation in elderly patients with T_(2)DM and CHD.