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投稿时间：2020-01-09 网络发布日期：2020-08-20
投稿时间：2020-01-09 网络发布日期：2020-08-20
中文摘要: 目的 研究利格列汀对老年2型糖尿病（T2DM）合并脑卒中轻度认知障碍患者血糖及认知能力的影响,探讨其作用机制。方法 选取2017年1月至2019年1月60例T2DM患者脑卒中后并发认知功能障碍患者,随机分为观察组和对照组,各30例。观察组运用利格列汀治疗,对照组采用磺脲类药物治疗。观察治疗前和治疗6个月后两组空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)水平;运用简易精神状态量表(MMSE)和蒙特利尔认知评估量表(MoCA)进行认知功能评估并比较;测定并比较血浆中β淀粉样蛋白(Aβ)1-40、Aβ1-42水平,及血清C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α、白介素(IL)-6等炎性因子水平。结果 两组患者治疗后FBG、2hPG、HbA1c水平均低于治疗前(P<0.05)。但治疗前后FBG、2hPG、HbA1c水平两组间比较无统计学差异(P>0.05)。治疗后,观察组MMSE、MoCA评分高于治疗前,且高于对照组(P<0.01)。治疗后,两组Aβ1-42/Aβ1-40高于治疗前,且观察组高于对照组(P<0.01)。治疗后,两组CRP、TNF-α、IL-6水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05,P<0.01)。结论 对老年T2DM合并脑卒中轻度认知障碍患者用利格列汀治疗，可降低患者血糖水平并改善认知,机制可能与改善Aβ聚集和降低体内炎症反应有关。
Abstract:ObjectiveTo study the influences of ligoliptin on blood glucose and cognitive function in elderly patients with type 2 diabetes mellitus (T2MD) complicated with mild cognitive impairment after stroke and its mechanism.MethodsSixty T2MD patients complicated with cognitive dysfunction after stroke were selected and randomly divided into observation group and control group (n=30,each).Ligoliptin was used in observation group,and sulfonylurea was used in control group.The levels of fasting blood glucose (FBG),2-hour postprandial blood glucose (2hPG) and HbA1c were observed before and 6 months after treatment.The cognitive function was evaluated by Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) and compared between two groups.Plasma amyloid β protein 1-40 (Aβ1-40) and Aβ1-42 levels and serum levels of inflammatory factors such as C-reactive protein (CRP),tumor necrosis factor (TNF)-α,interleukin (IL)-6 were measured and compared between two groups.ResultsAfter treatment,the levels of FBG,2hPG and HbA1c were statistically lower than those before treatment in two groups (P<0.05),however,there were no significant differences in them between two groups before and after treatment (P>0.05);MMSE and MOCA scores in observation group were higher than those before treatment and higher than those in control group (P<0.01);Aβ1-42/Aβ1-40 ratio was significantly higher than that before treatment in two groups and was higher in observation group than that in control group (P<0.01);the levels of CRP,TNF-α and IL-6 were statistically lower than those before treatment in two groups and were statistically lower in observation group than those in control group (P<0.05,P<0.01).ConclusionIn the treatment for elderly T2MD patients with mild cognitive impairment after stroke,liggliptin can reduce blood glucose and improve cognition,the mechanism of which may be related to the improvement of Aβ aggregation and the reduction of inflammatory response in vivo.
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基金项目:
| 作者 | 单位 |
| 张林1 | 1.南京中医药大学附属南京市中西医结合医院脑病科,江苏 南京210014； |
| 郑培华1 | 1.南京中医药大学附属南京市中西医结合医院脑病科,江苏 南京210014； |
| 张永文2 | 2.南京中医药大学附属南京市中西医结合医院内分泌科,江苏 南京210014 |
引用文本：
张林,郑培华,张永文.利格列汀对老年2型糖尿病合并脑卒中轻度认知障碍患者血糖及认知功能的影响[J].中国临床研究,2020,33(8):1062-1065.
张林,郑培华,张永文.利格列汀对老年2型糖尿病合并脑卒中轻度认知障碍患者血糖及认知功能的影响[J].中国临床研究,2020,33(8):1062-1065.