CAJ | 학술논문

目的：探讨环氧化酶（cox）-2在糖尿病性心肌病发生中的作用，筛选阻止糖尿病性心肌病发生的药物。方法在门诊及住院病房选取120例糖尿病患者为对照组，选取126例糖尿病性心肌病患者为观察组，根据干预措施不同，观察组随机分为常规治疗组（40例），银杏叶组（44例），复方丹参滴丸组（42例），治疗8周后，观察3组及各组治疗前后血脂、血糖、糖化血红蛋白（HbA1c）、心肌酶、cox-2、左室射血分数（LVEF）、E 峰/ A 峰变化。结果①与对照组相比，观察组总胆固醇（ TC）、总甘油三酯（ TG）、低密度脂蛋白胆固醇（ LDL）、血糖（ FBG、P2hBG）、HbA1c、心肌酶（CK、CKMB）、cox-2均显著升高，而高密度脂蛋白胆固醇（HDL）、LVEF、E 峰/ A 峰显著下降（P 均<0.05）；②治疗8周后，与常规治疗相比，银杏叶组、复方丹参滴丸组 CK、CKMB、cox-2均明显降低（P 均<0.05），银杏叶组降低更加明显（P 均<0.01）；③与复方丹参滴丸组相比，银杏叶组 cox-2显著下降（P <0.05）；但 CK、CKMB变化不明显（P 均>0.05）。④与治疗前相比，银杏叶组及复方丹参滴丸组 CK、CKMB、cox-2明显降低（ P 均<0.05）；LVEF、E 峰/ A 峰有升高趋势，但无统计学差异（P 均>0.05）。结论银杏叶提取物及复方丹参滴丸对糖尿病心肌病均有治疗作用，但银杏叶提取物治疗效果更优，其 cox-2可作为糖尿病心肌改善的早期指标。
목적：탐토배양화매（cox）-2재당뇨병성심기병발생중적작용，사선조지당뇨병성심기병발생적약물。방법재문진급주원병방선취120례당뇨병환자위대조조，선취126례당뇨병성심기병환자위관찰조，근거간예조시불동，관찰조수궤분위상규치료조（40례），은행협조（44례），복방단삼적환조（42례），치료8주후，관찰3조급각조치료전후혈지、혈당、당화혈홍단백（HbA1c）、심기매、cox-2、좌실사혈분수（LVEF）、E 봉/ A 봉변화。결과①여대조조상비，관찰조총담고순（ TC）、총감유삼지（ TG）、저밀도지단백담고순（ LDL）、혈당（ FBG、P2hBG）、HbA1c、심기매（CK、CKMB）、cox-2균현저승고，이고밀도지단백담고순（HDL）、LVEF、E 봉/ A 봉현저하강（P 균<0.05）；②치료8주후，여상규치료상비，은행협조、복방단삼적환조 CK、CKMB、cox-2균명현강저（P 균<0.05），은행협조강저경가명현（P 균<0.01）；③여복방단삼적환조상비，은행협조 cox-2현저하강（P <0.05）；단 CK、CKMB변화불명현（P 균>0.05）。④여치료전상비，은행협조급복방단삼적환조 CK、CKMB、cox-2명현강저（ P 균<0.05）；LVEF、E 봉/ A 봉유승고추세，단무통계학차이（P 균>0.05）。결론은행협제취물급복방단삼적환대당뇨병심기병균유치료작용，단은행협제취물치료효과경우，기 cox-2가작위당뇨병심기개선적조기지표。
Objective:To explore the role of oxidase(cox)-2 role in diabetic cardiomyopathy and to search the best to prevent it. Methods:120 cases of diabetic patients were selected from outpatient and inpatient wards as control group;and 126 patients with diabetic cardiomyopathy were chosen as observation group. according to different interventions. The ob-servation group were randomly divided into conventional treatment group(40 cases),ginkgo biloba group(44 cases), compound danshen dropping pill group(42 cases),and 8 weeks after treatment,blood fat,sugar,glycosylated hemoglobin (HbA1c),myocardial enzyme,cox-2,Left ventricular ejection fraction(LVEF),E/ A peak peak were observed in three groups and each group before and after treatment. Results:Compared with controls,total cholesterol(TC),triglyceride (TG),low density lipoprotein(LDL)cholesterol,blood glucose(FBG,P2hBG),HbA1c,myocardial enzymes(CK, CKMB),cox-2 were significantly increased,and high density lipoprotein cholesterol(HDL),LVEF,E peak/ A peak de-creased oberviously in the observation group(P < 0. 05). 2. Eight weeks after treatment,CK,CKMB,cox-2 were signifi-cantly lower in ginkgo biloba,compound danshen dropping pill groups compared with conventional treatment,(P < 0. 05), but they all reduced more significantly in Ginkgo biloba group(P < 0. 01). 3. Compared with the compound danshen drop-ping pill group,cox-2 significantly in ginkgo biloba group obviously decreased(P < 0. 05);but CK,CKMB change were not obvious(P > 0. 05). 4. Compared with those before treatment,CK,CKMB,cox-2 significantly decreased in biloba and compound danshen dropping pill group(P < 0. 05);and LVEF,E peak/ A peak had a rising trend,but there was no statistical difference(P > 0. 05). Conclusion:Both ginkgo biloba extract and compound danshen dropping pill have thera-peutic effect on diabetic cardiomyopathy,but the treatment effection of ginkgo biloba extract is better,and cox-2 can be used as early indicator of myocardial improvement in diaetes.