Hypertension:2型糖尿病患者长期应用短效GLP-1RA对系统血流动力学的影响

2018-08-07 MedSci MedSci原创

长期应用短效GLP-1RA(胰高血糖素样肽-1受体拮抗剂),如利西拉来,对2型糖尿病患者的空腹和餐后系统血流动力学的影响尚不明确。现Lennart Tonneijck等人针对这一点进行研究分析,将30位超重的采用甘精胰岛素治疗的2型糖尿病患者(平均±年龄 62±7岁;HbA1c 9.0±0.9%;收缩压[BP]133.9±16.1mmHg;舒张压[DBP]75.4±8.39mmHg),随机分至利西

长期应用短效GLP-1RA(胰高血糖素样肽-1受体拮抗剂),如利西拉来,对2型糖尿病患者的空腹和餐后系统血流动力学的影响尚不明确。

现Lennart Tonneijck等人针对这一点进行研究分析,将30位超重的采用甘精胰岛素治疗的2型糖尿病患者(平均±年龄 62±7岁;HbA1c 9.0±0.9%;收缩压[BP]133.9±16.1mmHg;舒张压[DBP]75.4±8.39mmHg),随机分至利西拉来组(20ug 1/日)或甘精胰岛素组(1/日),持续8周。分别于空腹和一份标准化的混合早餐后测量系统血流动力、动脉僵硬度和心脏交感迷走神经平衡。同时予以口服对乙酰氨基酚来估计胃排空率。

从起始到第8周,与甘精胰岛素相比,利西拉来不影响空腹系统血流动力学;但对于餐后收缩压和舒张压,利西拉来组较胰岛素组分别升高5.2±2.0mmHg(p=0.087)和5.4±1.4mmHg(p<0.001),最大差分别是+10.2±3.7mmHg(p=0.007)和+7.2±1.5mmHg(p<0.001)。此外,利西拉来还可增加全身血管阻力(p<0.001)和动僵硬度(p=0.007)。至于总体餐后心率、心排出量或心交感迷走平衡以及循环儿茶酚胺、血管紧张素II或醛固酮,两组间均未见明显差异。

两种治疗降低HbA1c的效果相似,利西拉来组餐后血糖降低幅度更大。利西拉来可降低胃排空率,可解释餐后BP的变化。对于采用甘精胰岛素治疗的2型糖尿病患者,采用利西拉来治疗8周,不影响空腹血压,但会增高餐后血压。该效应,在一定程度上可通过营养和水的通过率降低以及胃血管反射激活来解释。

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    2018-12-12 feather89
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  5. 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topicName=GLP-1RA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Aug 09 05:35:00 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474562, encodeId=c67a14e4562b9, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Aug 09 05:35:00 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-09 yibei
  6. 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  7. 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