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目的探讨前列地尔对2型糖尿病合并心力衰竭患者胰岛素抵抗、血脑钠肽和核因子-κB的影响。方法选取住院治疗的糖尿病合并心力衰竭患者80例,采用抽签法随机分为对照组(n=40)和治疗组(n=40)。在维持血糖、血压、血脂达标的情况下,对照组给予常规抗心力衰竭治疗,包括一般治疗与药物治疗,治疗组在此基础上加用前列地尔20pg,每日1次,共2周。治疗前后留取空腹血液标本,检测脑钠肽、核因子-κB,借助心脏超声检查评价患者心功能,计算胰岛素抵抗指数。结果治疗后,两组患者左心室射血分数、胰岛素抵抗指数、脑钠肽、核因子-κB均显著改善,并且胰岛素抵抗指数、脑钠肽、核因子-κB较对照组改善更好,差异有统计学意义(P﹤0.05)。结论前列地尔可显著增强2型糖尿病合并心力衰竭患者射血分数,纠正胰岛素抵抗,减少脑钠肽和核因子-κB的表达,进而改善患者的临床症状及预后。
Objective To investigate the effects of prostaglandin on insulin resistance, blood brain natriuretic peptide and nuclear factor-κB in patients with type 2 diabetes mellitus complicated with heart failure. Methods Eighty patients with diabetes mellitus and heart failure were selected and randomly divided into control group (n = 40) and treatment group (n = 40) by random selection. The patients in the control group were given conventional anti-heart failure treatment, including general treatment and drug treatment. The treatment group added alprostadil 20 pg once daily for 2 weeks in the condition of maintaining blood sugar, blood pressure and blood lipid. Fasting blood samples were taken before and after treatment, brain natriuretic peptide and nuclear factor-κB were measured, cardiac function was evaluated by echocardiography, and insulin resistance index was calculated. Results After treatment, left ventricular ejection fraction, insulin resistance index, brain natriuretic peptide and nuclear factor-κB were significantly improved in both groups, and insulin resistance index, brain natriuretic peptide and nuclear factor-κB were improved better than the control group There was statistical significance (P <0.05). Conclusion Alprostadil can significantly enhance the ejection fraction of type 2 diabetic patients with heart failure, correct insulin resistance, reduce the expression of brain natriuretic peptide and nuclear factor-κB, thereby improving the clinical symptoms and prognosis of patients.