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[大学生论坛]:糖尿病患者的血压应该控制到多少?

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fee. 发表于 2017-12-31 19:53:27 | 显示全部楼层 |阅读模式
本帖最后由 fee. 于 2017-12-31 19:59 编辑

糖尿病患者的血压应该控制到多少?
In what range should the blood pressure of diabetics be controlled to


作为一类经典的口服降糖药物,DPP-4抑制剂被广泛应用于糖尿病治疗。新近,陆军军医大学(第三军医大学)附属新桥医院内分泌科郑宏庭团队发布最新研究成果显示,DPP-4抑制剂可明显促进糖尿病创口修复,缩短愈合时间,且这种作用是独立于其降糖作用以外的额外获益。相关研究成果于12月19日在线发表于《Diabetes》。
DPP-4 inhibitant is widely used in diabetes as a classic oral antidiabetic drug(OAD). Recently a research which is led by a team from Xinqiao affiliated hospital to Third Military Medical University has shown that DPP-4 inhabitant is effective in repairing diabetic wounds, shortening the healing time, and it is an extra benefit which is independent of its hypoglycemic effect. The research was reported online December 19th 2017 in the journal Diabetes.

糖尿病患者常合并多种疾病,临床降糖药物多种多样,近来研究揭示一些抗糖尿病药物具有降糖作用之外的额外效应,并对这些疾病产生正面或者负面的影响 。因此,进一步了解降糖药物额外效应对优化临床降糖药物选择具有重要现实意义。
Patients of diabetes often have kinds of complications and there are various antidiabetic drugs for them. Recent study has shown that some antidiabetic drugs possess an extra benefits excepting blood glucose reducing, and affect those complications positively or negatively. Therefore, it is significant to learn more about the extra effect of antidiabetic drugs for optimization of clinical hypoglycemic drug selection.

该项研究表明,DPP-4抑制剂不仅可以直接诱导角质细胞发生EMT(Epithelial mesenchymal transition),还可以通过增强成纤维细胞表达SDF-1α间接诱导角质细胞发生EMT,从而促进其迁移,改善创口愈合;体内动物实验进一步揭示DPP-4抑制剂诱导创缘皮肤发生EMT,促进糖尿病小鼠创口愈合,但并不影响其体重和血糖;
This study suggested that DPP-4 inhibitant can not only directly induce epithelial mesenchymal transition(EMT) of horn cells, but also indirectly iuduce EMT of horn cells through enhancing the expression of fibroblast cells SDF-1α thereby promote healing. In vivo animal experiments, it further evidenced that DPP-4 inhibitant-induced EMT can promote wound repairment of diabetic mice without affecting the weight and blood glucose.

此外,DPP-4抑制剂还可以显著减少ECM相关基因(COL1A1、COL3A1和FN1)表达和胶原沉积,改善糖尿病溃疡疤痕形成。随后,纳入67名糖尿病溃疡患者展开临床随机对照试验,进一步证实DPP-4抑制剂对糖尿病溃疡的改善作用。Kaplan-Meir分析表明DPP-4抑制剂显著促进糖尿病溃疡愈合(Log rank=15.08, P=0.0001),然而,两组受试人群在纳入研究时以及观察期间血糖监测相关指标,包括FPG、HbA1C及2h PPG,均无差异。
In addition, DPP-4 inhibitant can significantly reduce expression of ECM-related genes(COL1A1, COL3A1, FN1)as well as collagen deposition, thus remove the diabetic ulcers. We conducted a randomized control trial including 67 diabetic patients, and proved the efficacy of DPP-4 inhibitant on diabetic ulcers. Kaplan-Meir analysis showed that DPP-4 inhibitant significantly promoted the healing of diabetic ulcer; while there was no significant difference in blood glucose monitoring between the two groups, including FPGV HbA1C and 2h PPG.

该研究揭示DPP-4抑制剂通过直接和间接诱导上皮细胞发生EMT以及减少瘢痕形成,从而改善糖尿病溃疡愈合,且这种作用可能独立于血糖控制之外。研究结果为糖尿病溃疡患者优先选用DPP-4抑制剂奠定了实验依据。值得注意的是,近来有研究报道DPP-4抑制剂可能增加肿瘤转移及心衰患者住院风险,基于上述研究结果,该团队强调DPP-4抑制剂在糖尿病个体化治疗方案中的合理应用。
The study reported that DPP-4 inhibitant promotes the healing of diabetic ulcers by directly and indirectly inducing EMT in epithelial cells thus reducing scar formation. And this effect may be independent of its blood sugar controlling effect. The results provide new information for diabetic ulcer patients on selection of DPP-4 inhibitant. Recent studies have reported that DPP-4 inhibitant may increase the risk of hospitalization in patients with tumor metastasis or heart failure.






Source:
http://news.medlive.cn/endocr/info-progress/show-137335_46.html
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