目的 探讨伏格列波糖联合合艾塞那肽治疗2型糖尿病患者的疗效及对血清微小RNA(miR)-29a及miR-342-5p表达的影响。方法 选取江苏省连云港市赣榆区人民医院2018年12月至2019年12月收治的106例2型糖尿病患者，根据治疗方法分为观察组与对照组，各53例，对照组予以艾塞那肽进行治疗，观察组在对照组基础上给予伏格列波糖治疗，比较2组患者临床疗效和治疗前后空腹血糖、餐后2 h血糖、糖化血红蛋白(glycated hemoglobin，HbA1c)等血糖指标水平，血清内皮素-1(endothelin-1，ET-1)、一氧化氮(NO)、动脉血流介导的内皮依赖性血管舒张功能(flow mediated dilation，FMD)等血管内皮功能指标水平和胰岛素(insulin，FINS)、胰岛素抵抗指数(homeostatic model assessment of insulin resistance，HOMA-IR)、胰岛素分泌指数(homeostasis model assessment-β，HOMA-β)等胰岛素 β 细胞功能及血清微 RNA(miR)-29a 及 miR-342-5p水平表达情况。结果 治疗后，观察组临床总有效率为96。2％(51/53)，对照组临床总有效率为83。0％(44/53)，2组比较差异有统计学意义(P＜0。05)。2组患者空腹血糖、餐后2 h血糖和HbA1c水平较治疗前降低，且观察组较对照组更低(P＜0。05)。治疗后，2组患者ET-1水平较治疗前降低，且观察组较对照组更低(P＜0。05)，而NO和FMD水平较治疗前升高，且观察组较对照组更高(P＜0。05)。治疗后，观察组FINS和HOMA-β较治疗前升高，而HOMA-IR较治疗前降低，且观察组优于对照组(P＜0。05)，而对照组治疗前后FINS、HOMA-β、HOMA-IR差异无统计学意义(P＞0。05)。治疗后，2组患者血清miR-29a和血清miR-342-5p水平较治疗前降低，且观察组较对照组更低(P＜0。05)。结论 伏格列波糖联合艾塞那肽治疗2型糖尿病患者可有效降低其血糖水平，改善血管内皮功能，改善胰岛素抵抗情况，降低血清miR-29a及miR-342-5p水平，控制病情进展，对改善预后具有积极意义。
Efficacy of voglibose combined with exenatide in the treatment of type 2 diabetes patients and its effect on serum miR-29a and miR-342-5p expression
Objective To investigate the efficacy of voglibose combined with exenatide in the treatment of patients with type 2 diabetes and its effect on the expression of serum miR-29a and miR-342-5p.Methods A total of 106 patients with type 2 diabetes admitted to Ganyu District People's Hospital from December 2018 to December 2019 were divided into observation group and control group depending on the treatment,53 cases in each group.The control group was treated with exenatide,and the observation group was treated with voglibose on the basis of the control group.The clinical efficacy,fasting blood glucose,2 h postprandial blood glucose,glycosy-lated hemoglobin(HbA1c)and other blood glucose indexes,serum endothelin-1(ET-1),nitric oxide(NO),flow me-diated dilation(FMD)and other vascular endothelial function indexes,insulin(FINS),homeostatic model assessment of insulin resistance(HOMA-IR),homeostasis model assessment-β(HOMA-β)and other insulin β cell functions and serum miR-29a and miR-342-5p levels were compared between the two groups before and after treatment.Results After treatment,the total effective rate of the observation group was 96.2％(51/53),and that of the control group was 83.0％(44/53).The observation group was higher than the control group(P＜0.05).The levels of fasting blood glucose,2 h postprandial blood glucose and HbA1c in the two groups were lower than those before treatment,and the observation group was lower than the control group(P＜0.05).After treatment,the levels of ET-1 in the two groups were lower than those before treatment,and the observation group was lower than the control group(P＜0.05),while the levels of NO and FMD were higher than those before treatment,and the observation group was higher than the control group(P＜0.05).After treatment,FINS and HOMA-B in the observation group were higher than those before treatment,while HOMA-IR was lower than that before treatment,and the observation group was significantly better than the control group(P＜0.05).After treatment,the levels of serum miR-29a and serum miR-342-5p in the two groups were lower than those before treatment,and those in the observation group were lower than the control group(P＜0.05).Conclusion Voglibose combined with exenatide in the treatment of patients with type 2 diabetes can effectively reduce their blood glucose levels,improve vascular endothelial function,im-prove insulin resistance,reduce serum miR-29a and miR-342-5p levels,and control disease progression.It has positive significance for improving prognosis and is worthy of clinical promotion.
万方数据
维普
