摘要
目的 探讨曲美他嗪对不稳定型心绞痛（UAP）并2型糖尿病（T2DM）患者血管内皮功能和胰岛素抵抗（IR）的影响.方法 选取UAP并T2DM患者72例,随机分为曲美他嗪组和对照组,每组36例.对照组给予常规治疗,曲美他嗪组在对照组基础上加用盐酸曲美他嗪,20 mg/次,3次/d.两组均治疗6个月.治疗前后检测血管内皮功能[血浆内皮素（ET-1）、一氧化氮（N0）、血管性血友病因子（vWF）及肱动脉血流介导的内皮依赖性舒张变化率（FMD）]及IR指标（空腹及服糖后2h血糖及胰岛素水平）.结果 治疗后,曲美他嗪组总有效率明显高于对照组（χ^2=4.1263,P〈0.05）;ET-1、NO、vWF及FMD均较对照组显著改善（t=2.9546,2.9382,3.6104,4.4721,P均〈0.01）;曲美他嗪组胰岛素水平明显低于对照组（t=2.3734,2.5427,P均〈0.05）,胰岛素敏感指数（ISI）明显高于对照组（t=2.2807,P〈0.05）.曲美他嗪组未发生与曲美他嗪相关的不良反应.结论 曲美他嗪具有改善血管内皮功能和减轻胰岛素抵抗的作用,对不稳定型心绞痛并T2DM患者安全有效.
Objective To investigate the effect of trimetazidine （TMZ） on vascular endothelial function and insulin resistance in patients with unstable angina pectoris（UAP） and type 2 diabetes mellitus（T2DM）.Methods Seventy-two patients with UAP and T2DM were randomly divided into trimetazidine group（36 cases） and control group （36 cases）.The control group received conventional therapy,and the TMZ group received TMZ on the basis of the control group,20 mg once,3 times a day.Two groups were treated for 6 months.All patients were detected vascular endothelial function [Endothelin （ET）,nitric oxide（NO）,von willebrand factor（vWF） and flow-mediated dilatation（FMD）] and IR indexes[（fasting and 2 hours after serving sugar） glucose and insulin levels] pretherapy and post-treatment.Results After treatment,the total effective rate in TMZ group was significantly higher than that in the control group（χ^2=4.1263,P 〈0.05）;The improvement of ET-1,NO,vWF and FMD in the TMZ group were better than those in the control group（t =2.9546,2.9382,3.6104,4.4721,all P 〈0.01）.The insulin level（fasting and 2 hours after serving sugar） in the TMZ group was significantly lower than that in the control group （t =2.3734,2.5427,all P 〈 0.05）.The insulin sensitivity index （ISI,fasting and 2 hours after serving sugar） in the TMZ group was significantly higher than that in the control group （t =2.2807,P 〈 0.05）.The TMZ group had no adverse reaction related to TMZ.Conclusions TMZ can improve vascular endothelial function and reduce insulin resistance,it is safe and effective for patients with UAP and T2DM.
出处
《中国实用医刊》
2016年第19期9-13,共5页
Chinese Journal of Practical Medicine
关键词
盐酸曲美他嗪
不稳定型心绞痛
2型糖尿病
血管内皮功能
胰岛素抵抗
Trimetazidine hydrochloride
Unstable angina pectoris
Type 2 diabetes mellitus
Endothelial function
Insulin resistance
