吡格列酮联合不同药物治疗糖尿病性心脏病的疗效及对心功能的影响

摘要

Objective:To study therapeutic effect of pioglitazone hydrochloride combined different drugs on diabetic cardiopathy (DC) and its influence on cardiac function.Methods:A total of 118 DC patients were selected from our hospital.They were randomly and equally divided into group A (received pioglitazone hydrochloride + nifedipine sustained release tablet ) and group B (received pioglitazone hydrochloride + α-lipoic acid + mecobalamin ),both groups were treated for two months.Related indexes of blood glucose,vascular endothelial function,islet β cell function,heart ejection function before and after treatment,and incidence of adverse reactions were observed and compared between two groups.Results:Compared with before treatment,there were significant reductions in levels of fasting blood glucose (FBG),2h postprandial blood glucose (2hPG),glycosylated hemoglobin A1c (HbA1c),ho-meostasis model-insulin resistance index (HOMA-IR),high sensitive C reactive protein (hsCRP),vascular endothe-lial cell protein C receptor (EPCR),plamsa thrombin regulation protein (TM) and von Willebrand factor (vWF),and significant rise in insulin sensitivity index (ISI),left ventricular ejection fraction (LVEF),left ventricular frac-tional shortening (LVFS) and left ventricular early diastolic peak flow velocity/late diastolic peak flow velocity (E/A) in two groups after treatment,P＝0.001 all.There were no significant difference in above indexes after treat-ment between two groups,P＞0.05 all.No obvious adverse reactions were found in two groups during treatment.Conclusion:Both pioglitazone hydrochloride + nifedipine sustained release tablet and pioglitazone hydrochloride +α-lipoic acid + mecobalamin can significantly reduce blood glucose level,improve insulin resistance,vascular endo-thelial function and cardiac function with low incidence rate of adverse reactions in DC patients,which is worth clin-ical application.%目的:研究盐酸吡格列酮联合不同药物治疗糖尿病性心脏病(DC)的疗效及对心功能的影响.方法:选择我院收治的DC患者118例,依据随机数字表法均分为A组(盐酸吡格列酮+硝苯地平缓释片治疗)与B组(盐酸吡格列酮+α-硫辛酸+甲钴胺治疗),治疗2个月.观察两组治疗前后血糖相关指标、血管内皮功能、胰岛β细胞功能、心脏射血功能及不良反应等指标.结果:与治疗前比较,治疗后两组空腹血糖(FBG ) 、餐后2h血糖(2hPG) 、糖化血红蛋白(HbA1c) 、胰岛素抵抗指数(HOMA-IR) 、高敏C反应蛋白(hsCRP) 、血管内皮细胞蛋白C受体(EPCR) 、血浆凝血酶调节蛋白(TM) 、血管性血友病因子(vWF)水平均显著降低;胰岛素敏感指数(ISI) 、左室射血分数(LVEF) 、左室短轴缩短分数(LVFS) 、左心室舒张早期峰值流速比舒张晚期峰值流速(E/A)明显升高(P均＝0.001);两组治疗后组间上述指标差异无统计学意义(P均＞0.05).治疗期间两组均未见明显不良反应.结论:盐酸吡格列酮+硝苯地平缓释片与盐酸吡格列酮+α-硫辛酸+甲钴胺治疗糖尿病性心脏病均可显著降低血糖,改善患者胰岛素抵抗、血管内皮功能,增强心功能,且不良反应发生率低,值得临床应用.