论文部分内容阅读
目的探讨吡格列酮对老年糖尿病合并冠心病患者血脂及CD34、CD133内皮细胞的影响。方法收集2013年3月至2015年9月我院收治的糖尿病合并冠心病患者92例,应用随机数字表法将患者分为吡格列酮组(47例)和对照组(45例),吡格列酮组在常规冠心病治疗的基础上加用吡格列酮降糖治疗;对照组在常规冠心病治疗基础上根据患者情况酌情选用磺脲类、双胍类、α-糖苷酶抑制剂等口服药或胰岛素注射进行降糖治疗,观察两组患者治疗前后血脂及CD34、CD133指标的变化。治疗前后效果对比及组间比较用t检验。结果治疗14 d后与治疗前相比,两组患者CD34、CD133水平差异无统计学意义(P>0.05);随访4周后,CD34、CD133水平明显高于治疗前,差异均有统计学意义(P<0.05),吡格列酮组CD34、CD133水平均明显高于对照组,差异均有统计学意义(P<0.05)。治疗14 d后与治疗前相比,TC、TG、LDL-C及HDL-C水平差异均无统计学意义(P>0.05);随访4周后,两组患者TC、TG、LDL-C水平较本组治疗前明显降低,HDLC水平明显升高,差异均有统计学意义(P<0.05),吡格例酮组TC、TG、LDL-C水平均明显低于对照组,HDL-C水平高于对照组,差异均有统计学意义(P<0.05)。结论吡格列酮在理想控制血糖水平的同时,能够增加患者外周血内皮祖细胞表达,并有效改善患者血脂状况,疗效确切,值得临床推广。
Objective To investigate the effect of pioglitazone on blood lipids, CD34 and CD133 endothelial cells in elderly patients with diabetes mellitus complicated with coronary heart disease. Methods Ninety-two patients with diabetes mellitus and coronary heart disease admitted from March 2013 to September 2015 in our hospital were divided into pioglitazone group (n = 47) and control group (n = 45) by random number table method. Patients in pioglitazone group On the basis of conventional treatment of coronary heart disease, the control group was given oral hypoglycemic agents such as sulfonylureas, biguanides, α-glycosidase inhibitors and insulin or insulin injections according to the patients’ condition The changes of blood lipid, CD34 and CD133 in two groups before and after treatment were observed. Before and after treatment effect comparison and comparison between groups using t test. Results There was no significant difference in the levels of CD34 and CD133 between the two groups after 14 days of treatment (P> 0.05). After 4 weeks of follow-up, the levels of CD34 and CD133 were significantly higher than those before treatment (P <0.05), pioglitazone group CD34, CD133 levels were significantly higher than the control group, the difference was statistically significant (P <0.05). There was no significant difference in the levels of TC, TG, LDL-C and HDL-C between the 14th day and the 4th day after treatment (P> 0.05). After 4 weeks of follow-up, TC, TG and LDL-C Compared with the control group, the levels of TC, TG and LDL-C in pioglitazone group were significantly lower than those in the control group and HDL-C levels were significantly lower than those in the control group (P <0.05) Higher than the control group, the difference was statistically significant (P <0.05). Conclusion Pioglitazone can increase the expression of endothelial progenitor cells in peripheral blood of patients with ideal control of blood glucose levels and effectively improve the blood lipid status of patients with definite curative effect. It is worthy of clinical promotion.