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目的观察2型糖尿病病人口服阿司匹林后高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)及肿瘤坏死因子α(TNF-α)血清浓度的变化。方法82例2型糖尿病病人,分成2组。试验组与对照组病人均给予常规降糖和降压治疗,试验组病人加服阿司匹林100mg·d-1,观察1年。分别于观察开始和1年后测定空腹血糖(FBG)、胰岛素(FINS)、糖化血红蛋白(HbA1c)和血清hs-CRP、IL-6、TNF-α等水平。结果治疗后,2组病人FBG和HbA1c均明显下降,与治疗前相比差异非常显著(P<0.01),其中试验组FBG下降幅度大于对照组(P<0.01)。试验组FINS和胰岛素抵抗指数也下降,而对照组无显著变化,2组有非常显著差异(P<0.01)。试验组hs-CRP、IL-6和TNF-α分别下降(1.2±s0.4)mg·L-1、(6±4)ng·L-1和(6±7)ng·L-1,下降幅度明显大于对照组(0.13±0.05)mg·L-1、(0.02±0.13)ng·L-1和(1.3±1.0)ng·L-1,差异非常显著(P<0.01)。试验组出现恶心、上腹部不适2例,停药1例。结论阿司匹林能降低2型糖尿病病人的炎症因子水平,抗炎治疗可作为预防和治疗2型糖尿病的一种方法。
Objective To observe the changes of serum hs-CRP, IL-6 and TNF-α levels after oral aspirin in type 2 diabetic patients. Methods 82 patients with type 2 diabetes mellitus were divided into two groups. The patients in test group and control group were given routine hypoglycemic and antihypertensive treatment. Patients in test group were given aspirin 100 mg · d-1 for 1 year. Fasting blood glucose (FBG), insulin (FINS), glycosylated hemoglobin (HbA1c) and serum hs-CRP, IL-6 and TNF-α were measured at the beginning of the observation and one year later. Results After treatment, the FBG and HbA1c in two groups were significantly decreased (P <0.01), and the FBG decrease in the experimental group was larger than that in the control group (P <0.01). FINS and insulin resistance index of the experimental group also decreased, but there was no significant change in the control group, there was a significant difference between the two groups (P <0.01). The levels of hs-CRP, IL-6 and TNF-α in the experimental group were decreased by (1.2 ± s0.4) mg · L-1, (6 ± 4) ng · L-1 and (6 ± 7) ng · L- (0.13 ± 0.05) mg · L-1, (0.02 ± 0.13) ng · L-1 and (1.3 ± 1.0) ng · L-1, respectively. The difference was significant (P <0.01). The experimental group showed nausea, upper abdominal discomfort in 2 cases and discontinuation in 1 case. Conclusion Aspirin can reduce the level of inflammatory cytokines in type 2 diabetic patients and anti-inflammatory therapy can be used as a method to prevent and treat type 2 diabetes mellitus.