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Objective To investigate the efficacy and safety of dipeptidyl peptidase 4(DDP-4)inhibitor in the treatment of diabetes mellitus.Methods Eighty-six cases patients with poor glycemic control in type 2 diabetes mellitus in Shunde First People's Hospital of Foshan from May 2015 to May 2016 were selected as the research objects and divided into two groups according to random number table method,each group with 43 cases.The control group with acarbose(50 mg/times,3 times/d,with the same as the 3 meals,sustained medication for 12 weeks)to control blood sugar,while the observation group used DPP-4 inhibitors sitagliptin(100 mg/times,1 times/d,sustained medication for 12 weeks),compared the blood glucose,blood lipid indexes and adverse reactions of two groups before and after treatment.Results After treatment,FPG,2 hPG,HbAlc level of observation group were respectively(6.71±0.65)mmol/L,(8.10±0.17)mmol/L,(7.12±0.41)％,significantly lower than control group((7.86±0.72)mmol/L,(9.20±0.65)mmol/L,(7.51±0.52)％,the differences were statistically significant(P＜0.01).After treatment,there were no significant differences in terms of TC,TG,HDL-C,LDL-C between two groups(P＞0.05).Treatment for 12 weeks,the blood glucose compliance rate of observation group was 88.37％(38/43),the control group was 67.44％(29/43),the observation group was significantly higher than the control group(P=0.019).After treatment,the HOMA-IR value of the observation group was 4.42±0.17,significantly lower than the control group(4.91±0.24),HOMA-beta value was 88.20±6.31,significantly higher than that of the control group(80.21±5.67),the differences were significant(P＜0.01).Conclusion DDP-4 inhibitor in the treatment of type 2 diabetes,can effectively reduce the level of blood glucose and glycosylated hemoglobin,and have no significant adverse reactions,is effective and safe hypoglycemic drugs.
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Objective To evaluate the outcome of incomplete revasculariszation by percutaneous coronary intervention (PCI) in elderly patients with coronary artery disease.Methods Data of 48 patients (age≥75 years old) underwent incomplete coronary revascularization during the period from 2008 to 2011 were collected.Their data before PCI and the 6 months follow-up results were comparatively analyzed.Results Six months after incomplete coronary revascularization,the LVEF was higher than that before revascularization ((48.10 ± 7.19)％ vs (39.82 ± 8.23)％) and BNP declined significantly ((575.17 ± 67.27) ng/L vs (793.57 ± 87.53)ng/L).T peak-T end (Tp-Te) √RR and Tp-Te/QT also declined significantly (Tp-Te √RR:(96.38 ± 10.79)ms vs (147.81 ± 17.32)ms;Tp-Te/QT:(0.25 ±0.05) vs (0.30 ±0.07)) (P ＜0.05).Six months after PCI,LVEDV and LVESV were higher than those before surgery,but there was no significant difference(P ＞ 0.05).Conclusion Incomplete coronary revascularization can improve heart function and stability of cardiac electrophysiology in elderly patients with coronary artery disease,but it can not prevent the development of left ventricular remodeling.
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Objective To investigate the value of intravenous arginine stimulation test (AST) in evaluating function of pancreatic islet beta cell response in patients of diabetes mellitus. Methods Twentyone patients with type 1 diabetes mellitus (DM1, DM1 group) and 113 patients with type 2 diabetes mellitus (DM2, DM2 group) were recruited in this study. DM2 patients were divided into two sub-groups, DM2a group (duration of no more than 1 year, 58 patients) and DM2b group (more than 1 year, 55 patients). The serum levels of C-peptide (CP) were determined at fasting and 2,3,4,5 minutes after intravenous injection of 5 g arginine. Results In DM1 group, the level of CP after injection of arginine was. similar to the fasting level (P> 0.05 ). In DM2 group, the peak level of CP appeared at 3th minute (CP3) during AST, and was significantly higher than fasting CP level(P < 0.01 ). The level of fasting and arginine-stimulated CP in DM2a group was significantly higher than that in DM2b group, and the level of fasting and arginine-stimulated CP in DM2b group was significantly higher than that in DM1 group. The patients of DM1 group whose level of CP3 < 600 pmol/L all needed insulin injection to control hyperglycemia, and the coincident rate was 100.0%.In DM2 group, there were 91 patients whose CP3 ≥600 pmol/L, among which 85 patients could be well controlled with diet or oral hypoglycemic agents, and the coincidentrate was 93.4%; there were 22 patients whose CP3 < 600 pmol/L, among which 19 patients need insulin injection to control hyperglycemia, and the coincident rate was 86.4%. Conclusions AST is valuable in assessing the function of pancreatic islet beta cell in patients with diabetes mellitus. The level of CP3 ≥600 pmol/L can be considered as a reference in diagnosis and treatment of diabetes mellitus.
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Objective To evaluate the effects of time selection and immediate percutneous transluminal coronary angioplasty (PTCA) in refractory unstable angina pectoris.Methods PTCA was performed in 27 RUAP patients,among which 16 underwent emergency PTCA and 11 patients experienced PTCA after controlling with medicine.ECG and recurrence of symptoms were observed immediately and 6 months after PTCA.Results The procedural success rate was 100%.The immediate relieving rate was 96.3%.The recurrence rate of 11 cases within 6 months (18.2%)was significantly lower than that of 16 cases(37.5%).Conclustion The PTCA for RUAP is relatively safe and effective,but PTCA should be performed after situation is unchanged by use of medicine and PTCA shoulde be carried out immediately if the symptoms can not be controlled by medicine.
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Objective To evaluate the safety and efficacy of low-molecular weight heparin on the prevention of acute closure after percutaneous intracavitary coronary angioplasty.Methods 73 patients were randomly assigned to LMWH and SH groups.All patients underwent SPECT or CAG.Myocardial ischemia and hemorrhage complication were analyzed.Results In Group LMWH,no case of hemorrhage complication occurred,and in 3 cases angina occurred within 24h after the operation,which was proved by CAG to be acute closure of target vessel (the incidence rate 8.6%) .In Group SH,gum and subcutaneous hemorrhage occurred to 2 cases within 7h after the operation,hematuria occurred to 2 cases within 12h and one case died from cerebral hemorrhage,which was confirmed by CT (the total hemorrhage incidence 13.2%).Another 4 cases in Group SH suffered from re-occurrence of angina,which was confirmed by CAG to be acute closure of target vessel (10.5%).There was significant difference in hemorrhage complication between the two groups (P0.05)。Conclusion The results suggest that LMWH is safe and effective in the prevention of acute closure after native vessel coronary angioplasty.