目的：分析利格列汀对糖尿病合并冠心病患者内质网应激指标及心血管事件发生率的影响。方法：回顾性选择2021年3月—2024年4月我院住院102例糖尿病合并冠心病患者,依据治疗方案分为研究组（52例,常规+利格列汀治疗）;对照组（50例,常规治疗）。比较干预前和干预3个月后两组患者的心功能指标包括左室射血分数（left ventricular ejection fraction,LVEF）、每搏输出量（stroke volume,SV）、左室舒张末期内径（left ventricle end diastolic diameter,LVEDd）;比较干预3个月后两组患者血清内质网应激指标[葡萄糖调节蛋白78（glucose regulated protein 78ku,CRP78）、天冬半胱氨酸特异性蛋白酶-12（cysteine-containing aspartate-specific proteases-12,Caspase-12）、CCAAT/增强子结合蛋白（CCAAT/enhancer binding protein,CHOP）]。Pearson分析两组患者干预3个月后血清GRP78、CHOP、Caspase-12水平与LVEF的相关性。结果：所有患者干预后心功能指标较干预前恢复更好,差异均具有统计学意义;且干预后研究组患者LVEF（62.87±4.96%）、SV（64.38±5.18 mL）均高于对照组LVEF（56.64±4.86%）、SV（54.46±4.88 mL）,研究组患者LVEDd（56.87±4.28 mm）低于对照组LVEDd（59.08±4.36 mm）,但无显著性差异。与对照组比较,研究组利格列汀干预后内质网应激指标GRP78、CHOP、Caspase-12水平降低。Pearson分析显示,干预后研究组患者血清GRP78（r=-0.678,P<0.05）、CHOP（r=-0.679,P<0.05）、Caspase-12（r=0.555,P<0.05）水平与其LVEF水平呈负相关,而对照组患者血清GRP78、CHOP、Caspase-12水平与其LVEF水平均无显著相关性。结论：利格列汀治疗可降低糖尿病合并冠心病患者内质网应激反应,但对心血管事件无明显影响。
Abstract
Objective To analyze the effect of linagliptin on the endoplasmic reticulum stress index and the incidence of cardiovascular events in patients with coronary heart disease and diabetes. Methods From March 2021 to April 2024, we identified 102 patients with coronary heart disease and diabetes for a retrospective study. They were allocated into two groups based on treatment protocols: the study group (n=52) receiving conventional therapy plus linagliptin, and the control group (n=50) on standard care. Cardiac function parameters (LVEF, SV, LVEDd) were assessed pre- and post-intervention at 3 months. Serum endoplasmic reticulum stress markers (GRP78, Caspase-12, CHOP) were compared after 3 months. Pearson correlation was used to evaluate the relationship between serum GRP78, CHOP, Caspase-12 levels, and LVEF at this time point. Results Post-intervention, both the study and control groups exhibited enhanced LVEF and SV, alongside a reduction in LVEDd. Notably, the study group demonstrated a more favorable recovery in cardiac function, though this was not statistically significant compared to the control. Following sitagliptin treatment, the study group saw a significant decline in endoplasmic reticulum stress markers GRP78, CHOP, and Caspase-12 compared to the control. Pearson correlation revealed that in the study group, serum levels of GRP78 (r=-0.678, P<0.05), CHOP (r=-0.679, P<0.05), and Caspase-12 (r=0.555, P<0.05) were inversely associated with LVEF. In contrast, the control group did not exhibit a significant correlation between these serum markers and LVEF. Conclusion Lipagliptin therapy diminishes the ER stress response in coronary heart disease and diabetic patients without notably affecting cardiovascular incidents.
关键词
利格列汀 /
2型糖尿病合并冠心病 /
心功能 /
内质网应激反应 /
心血管事件
Key words
ligliptin /
type 2 diabetes with coronary heart disease /
endoplasmic reticulum stress /
cardiovascular events
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参考文献
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基金
湖北省卫生健康委2024年度卫生科研课题“利格列汀对糖尿病合并冠心病患者内质网应激指标及心血管事件的影响”（W20241026）
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