摘要目的 分析利拉鲁肽(Liraglutide)联合冠状动脉介入(PCI)对急性心肌梗死(AMI)伴2型糖尿病(T2DM)患者术后心肌损伤、心室重构及心功能的影响.方法 80例AMI伴T2DM患者随机分成2组,各40例,对照组患者接受二甲双胍+常规胰岛素联合PCI术治疗,观察组患者接受二甲双胍+利拉鲁肽联合PCI治疗.对比两组患者的体重、血糖、胰岛素、心室重构指标、心功能指标及血清相关指标值差异.结果 (1)观察组治疗后3个月的体重、空腹血糖水平均明显低于对照组(P＜0.05),空腹胰岛素水平明显高于对照组( P＜0. 01). ( 2)观察组治疗后 3 个月的 B 型利钠肽前体( N-terminal-pro-B-type natriuretic peptide, NT-proBNP)、磷酸激酶同工酶-MB(creatine kinase isoenzymes-MB, CK-MB)和肌钙蛋白I( Troponin I, TnI)水平均明显低于对照组(P＜0.05). (3)观察组治疗后3个月的血清超敏C-反应蛋白(hypersensitive C-reactive protein, hs-CRP)、肿瘤坏死因子α(tumor necrosis factor-α, TNF-α)、白细胞介素6( interleukin-6, IL-6)水平均明显低于对照组(P＜0.05). (4)观察组治疗后3个月的左室收缩末期内径、左室舒张末期内径、室间隔厚度、左室后壁厚度、左室重量指数、左室收缩末期容积、左室舒张末期容积值低于对照组(P＜0.05),左室短轴缩短率、左室射血分数、二尖瓣血流舒张早期流速/心房收缩期流速值高于对照组( P＜0.05).结论 AMI伴T2DM患者给予利拉鲁肽联合PCI治疗可减轻心肌损伤、心室重构,加强心功能,改善预后.

abstractsObjective To analyze the influence of liraglutide intervention combined percutanous coronary intervention(PCI) therapy on acute myocardial infarction( AMI) with type 2 diabetes( T2DM) patients'myocardial injury, ventricular remodeling( VR), and cardiac function. Methods Eighty patients with AMI and T2DM were included in the study, and they were randomly divided into observation group and control group according to the random number table, each with 40 patients. The patients in the control group received metformin and conventional insulin combined PCI treatment, and the patients in the observation group received metformin and liraglutide combined PCI treatment. The changes in the values of ventricular remodeling indexes, cardiac function and serum related indexes were compared after 3 months treatment between the two groups. Results ( 1) The body weight and fasting blood glucose levels of the observation group were significantly lower than those of the control group( P＜0.05), and fasting insulin levels were significantly higher than those of the control group(P＜0.01). (2)The levels of N-terminal-pro-B- type natriuretic peptide ( NT-proBNP ), creatine kinase isoenzymes-MB ( CK-MB), and troponin I ( TnI) in the observation group 3 months after treatment were significantly lower than those in the control group(P＜0.05). (3)The levels of serum hypersensitive C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) in the observation group were significantly lower than those in the control group 3 months after treatment( P＜0. 05). ( 4) The values of left ventricular end systolic diameter ( LVESD ), left ventricular end diastolic diameter (LVEDD), interventricular septum thickness ( IVST), left ventricular posterior wall thickness ( LVPWT), left ventricular mass index ( LVMI), left ventricular end systolic volume ( LVESV), and left ventricular end diastolic volume(LVEDV) in the observation group were lower than those in the control group; the values of left ventricular fraction shortening(LVFS), left ventricular ejection fraction(LVEF), and mitral valve early diastolic blood flow rate (VE)/atrial systolic flow velocity ( VA), all were higher than those of the control group ( P＜0. 05). Conclusion Lraglutide intervention combined with PCI therapy on AMI with T2DM patients may reduce myocardial injury, induce ventricular remodeling, enhance cardiac function, and improve prognosis.