司美格鲁肽对2型糖尿病并ASCVD住院患者的临床疗效分析

Clinical Efficacy of Semaglutide in Inpatients with Type 2 Diabetes Mellitus Combined with Atherosclerotic Cardiovascular Disease

目的:分析司美格鲁肽对2型糖尿病(T2DM)合并动脉粥样硬化性心血管疾病(ASCVD)住院患者的临床疗效。方法:选取2022年12月—2023年12月佳木斯市中心医院收治的60例T2DM合并ASCVD(T2DM-ASCVD)住院患者,采用随机数字表法将其分为两组,每组30例。对照组采用预混胰岛素治疗,观察组采用预混胰岛素联合司美格鲁肽治疗。比较两组糖代谢、血压、体重和脂代谢指标水平,颈动脉超声参数,血清骨膜蛋白(POSTN)水平,不良反应和主要不良心血管事件(MACE)发生率。结果:治疗后,两组糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)和收缩压(SBP)、舒张压(DBP)均较治疗前降低,且观察组均低于对照组(P<0.05)。治疗后,两组体重和总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均较治疗前降低,且观察组均低于对照组(P<0.05)。治疗后,两组颈动脉内膜中层厚度(IMT)、颈动脉斑块积分(Crouse积分)和血清POSTN水平均较治疗前降低,且观察组均低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05),但观察组MACE发生率低于对照组(P<0.05)。结论:司美格鲁肽可有效调控T2DM-ASCVD患者的血糖、血脂代谢,并可减重、降压、减少颈动脉斑块的数量和面积、降低血清POSTN水平、降低MACE发生风险。

Objective:To analyze the clinical efficacy of Semaglutide in inpatients with type 2 diabetes mellitus(T2DM)combined with atherosclerotic cardiovascular disease(ASCVD).Method:Sixty inpatients with T2DM combined with ASCVD(T2DM-ASCVD)admitted to Jiamusi Central Hospital from December 2022 to December 2023 were selected and divided into two groups with 30 cases in each group by random number table method.The control group was treated with premixed insulin,and the observation group was treated with premixed insulin combined with Semaglutide.The levels of glucose metabolism,blood pressure,body weight and lipid metabolism,carotid ultrasound parameters,serum periostin(POSTN)levels,incidences of adverse reactions and major adverse cardiovascular events(MACE)were compared between the two groups.Result:After treatment,glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 h PG),systolic blood pressure(SBP)and diastolic blood pressure(DBP)in both groups were lower than those before treatment,and those of observation group were lower than those of control group(P<0.05).After treatment,body weight,total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in both groups were lower than those before treatment,and those of observation group were lower than those of control group(P<0.05).After treatment,the levels of carotid intium-media thickness(IMT),carotid plaque scores(Crouse scores)and serum POSTN in both groups were lower than those before treatment,and those of the observation group were lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05),but the incidence of MACE in the observation group was lower than that in the control group(P<0.05).Conclusion:Semiglutide can effectively regulate blood glucose and lipid metabolism in T2DM-ASCVD patients,and can reduce weight,blood pressure,the number and area of carotid plaque,serum POSTN level,and the risk of MACE.