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目的:探讨DPP-4抑制剂在左心室重塑的糖尿病患者中的治疗作用及其对心肌标志物表达水平的影响。方法:2014年3月至2016年3月随机选择128例就诊于武汉科技大学附属普仁医院的2型糖尿病患者,按照随机对照原则分为研究组及对照组,研究组在胰岛素治疗基础上联合使用DPP-4抑制剂治疗,持续治疗3个月后超声评价两组患者左心室舒张末径(LVEDD)、左心室收缩末径(LVESD)、左心室射血分数(LVEF)等指标,检测治疗前后患者血清心肌标志物水平以及空腹血糖水平,并进行统计学分析。结果:两组患者空腹血糖未见明显差异,但研究组患者LVEDD、LVESD明显小于对照组,而LVEF明显增加,CK-MB显著高于对照组,cTnI明显低于对照组,差异具有统计学意义(P<0.05)。结论:在2型糖尿病患者中,联合使用DPP-4抑制剂可以减缓心室肌重塑的进程、减轻心肌损伤,此外,在胰岛素治疗基础上,DPP-4抑制剂并不明显降低患者空腹血糖水平,对于稳定患者空腹血糖水平具有重要临床意义。
Objective: To investigate the therapeutic effect of DPP-4 inhibitor in diabetic patients with left ventricular remodeling and its effect on the expression of myocardial markers. Methods: From March 2014 to March 2016, 128 randomly selected type 2 diabetic patients attending Purin Hospital Affiliated to Wuhan University of Science and Technology were divided into study group and control group according to the principle of randomized control. The study group was united on the basis of insulin therapy Using DPP-4 inhibitor therapy, LVEDD, LVESD and LVEF were measured by ultrasound after three months of continuous treatment. Before and after patients with serum myocardial markers and fasting blood glucose levels, and statistical analysis. Results: There was no significant difference in fasting blood glucose between the two groups. However, the LVEDD and LVESD in the study group were significantly lower than those in the control group, while the LVEF and CK-MB in the study group were significantly higher than those in the control group (P <0.05). CONCLUSIONS: In patients with type 2 diabetes, the combination of DPP-4 inhibitors slows the progression of ventricular remodeling and reduces myocardial damage. In addition, DPP-4 inhibitors do not significantly reduce fasting plasma glucose levels on the basis of insulin therapy , For the stability of patients with fasting blood glucose level has important clinical significance.