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目的:观察丹参多酚酸盐联合甲钴胺治疗对糖尿病性心肌病患者血清中血管紧张素转化酶2(ACE2)和血管紧张素1-7(Ang-(1-7))含量的影响。方法:将80例糖尿病性心肌病患者随机分为对照组和观察组,每组40例。两组患者均给予甲钴胺等常规药物治疗,观察组加用丹参多酚酸盐治疗。比较两组临床疗效,同时检测患者血清Ang II、ACE2、Ang-(1-7)水平,氧化应激指标MDA和SOD,血糖指标FBG、PBG和Hb A1c,心功能参数EF、PE、PA和E/A等指标变化情况,记录不良反应。结果:观察组治疗总有效率为87.50%,明显高于对照组的65.00%;治疗后,观察组较对照组Ang II水平明显降低,ACE2、Ang(1-7)水平明显升高;治疗后,观察组较对照组SOD水平明显升高,MDA水平均明显降低;治疗后,观察组较对照组FBG、PBG、Hb A1c水平均明显降低;治疗后,观察组较对照组EF、PE、PA、E/A均明显改善;两组不良反应发生率均不明显,对比无差异。结论:丹参多酚酸盐可能通过升高血清ACE2、Ang-(1-7)水平,而发挥抗氧化应激,抗炎症、调节血糖平衡等心功能保护作用,联合甲钴胺治疗糖尿病心肌病,可明显改善患者心功能,提高治疗效果。
Objective: To observe the effect of salvianolate combined with mecobalamin on serum angiotensin converting enzyme 2 (ACE2) and angiotensin 1-7 (Ang- (1-7)) in patients with diabetic cardiomyopathy. Methods: 80 patients with diabetic cardiomyopathy were randomly divided into control group and observation group, 40 cases in each group. Two groups of patients were given conventional mecobalamin drug treatment, the observation group plus salvianolate treatment. The serum levels of Ang II, ACE2, Ang- (1-7), MDA and SOD, FBG, PBG and Hb A1c, EF, PE, PA and E / A and other indicators of changes, record adverse reactions. Results: The total effective rate of observation group was 87.50%, which was significantly higher than that of control group (65.00%). After treatment, Ang II level and ACE2 and Ang (1-7) levels in observation group were significantly lower than those in control group The levels of FBG, PBG and Hb A1c in the observation group were significantly lower than those in the control group; after treatment, the levels of SOD, PE and PA in the observation group were significantly higher than those in the control group , E / A were significantly improved; two groups of adverse reactions were not significant, the contrast was no difference. CONCLUSION: Salviae miltiorrhizae polyphenols may exert cardiac protective effects such as anti-oxidative stress, anti-inflammation and blood-glucose balance by increasing serum ACE2 and Ang- (1-7) levels. Combined with mecobalamin in the treatment of diabetic cardiomyopathy , Can significantly improve the patient’s cardiac function and improve the treatment effect.