沙格列汀对改善2型糖尿病患者血压的效果及其作用机制

摘要

Objective To investigate the blood pressure-lowing effects of saxagliptin in patients with type 2 diabetes, to study the mechanisms of the beneficial effects of saxagliptin on heart and blood vessels .Methods 78 patients with type 2 diabetes mellitus failing in blood glucose control but with stabilized blood pressure or not having their hypotensive drugs changed over the previous three months were randomly divided into study group (43) and control group(35).The study group was treated with saxagliptin while the control group received increased original dose or added with other hypoglycemic agents for three months .Then the levels of fasting and postprandial blood glucose,glycosylated hemoglobin(HbA1c),body mass index(BMI),and blood pressure were measured after thera-py.Results The fasting plasma glucose (FPG), postprandial glucose (PPG) and HbA1c significantly decreased after treatment in the two groups (P<0.05);while the systolic blood pressure (SBP) [ (133.9 ±16.5) mmHg vs (125.2 ±13.4) mmHg),P<0.01], 24 h mean systolic blood pressure [ (125.2 ±11.7) mmHg vs (116.6 ±8.6) mmHg,P<0.01] decreased significantly in treatment group after treatment , but no significant change in the control group .However , the degree of the decrease in HbA 1 c、FPG and PPG levels was not significantly correlated with that of SBP by Spearman rank correlation .Conclusions Saxagliptin decreases not only blood glucose but also systolic pressure in patients with type 2 diabetes mellitus .%目的：观察沙格列汀改善2型糖尿病（type 2 diabetes mellitus，T2DM）患者血压的效果，并探讨其心血管保护作用的机制。方法选取血糖控制不佳而血压控制平稳的T2DM 78例，随机分为治疗组43例和对照组35例，两组在原有口服药物基础上，治疗组加用沙格列汀，对照组增加原有药物剂量或加用其他降糖药。治疗3个月后，观察两组治疗前后血糖、糖化血红蛋白（ HbA1 c）、体重指数（ BMI）及血压变化。结果两组治疗后空腹血糖（ fasting plasma glucose ，FPG）、餐后血糖（ post-prandial glucose，PPG）、HbA1c较前均明显下降（P＜0．05）；治疗组收缩压（SBP）[（133．9±16．5） mmHg vs （125．2±13．4） mmHg，P＜0．01]、24 h平均收缩压较治疗前明显下降[（125．2±11．7） mmHg vs（116．6±8．6）mmHg，P＜0．01]，但对照组以上指标较治疗前无明显变化。 Spearman相关分析显示治疗组血压下降与空腹、餐后血糖及HbA1 c下降均无关。结论沙格列汀不仅能降低T2 DM患者血糖，而且对血压也具有改善作用。