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目的:探讨维格列汀对新诊断2型糖尿病患者血管内皮细胞功能的影响。方法:将2012年1月至2013年6月收治的70例新诊断2型糖尿病患者随机分为维格列汀组和二甲双胍组,每组各35例。治疗前后分别测定患者肱动脉血流介导的血管舒张(FMD)、空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、血脂、脂联素、肿瘤坏死因子α(TNF-α)和C反应蛋白(CRP)。结果:治疗24周后,两组FMD、脂联素均较治疗前增加(P<0.05),Hb A1c、FBG、TG、CHOL、LDL-C、TNF-α、CRP均较治疗前降低(P<0.05);维格列汀组治疗后FINS较治疗前增加(P<0.05),二甲双胍组治疗后FINS与治疗前比较,差异无统计学意义(P>0.05)。其中维格列汀组FMD、脂联素增加,TNF-α降低较二甲双胍组明显(P<0.05);二甲双胍组Hb A1c、FBG、血脂下降较维格列汀组更明显(P<0.05)。结论:维格列汀可改善新诊断2型糖尿病患者血管内皮细胞功能,且这种作用优于二甲双胍。
Objective: To investigate the effect of vildagliptin on the function of vascular endothelial cells in newly diagnosed type 2 diabetic patients. Methods: Seventy patients with newly diagnosed type 2 diabetes who were admitted from January 2012 to June 2013 were randomly divided into vildagliptin group and metformin group, with 35 cases in each group. Before and after treatment, brachial artery blood flow-mediated vasodilation (FMD), fasting blood glucose (FBG), Hb A1c, FINS, lipids, adiponectin and tumor necrosis factor alpha (TNF- α) and C-reactive protein (CRP). Results: After 24 weeks treatment, the levels of FMD and adiponectin in both groups increased (P <0.05) and the levels of Hb A1c, FBG, TG, CHOL, LDL-C, TNF- (P <0.05). The FINS in the Vildagliptin group was significantly higher than that before the treatment (P <0.05). There was no significant difference in the FINS between the two groups after metformin treatment (P> 0.05). The levels of FMD, adiponectin and TNF-α decreased significantly in vildagliptin group compared with metformin group (P <0.05). The decrease of Hb A1c, FBG and lipid in metformin group was more obvious than that of vildagliptin group (P <0.05). Conclusion: Vildagliptin can improve the function of vascular endothelial cells in patients newly diagnosed with type 2 diabetes mellitus, and this effect is superior to that of metformin.