目的:观察高选择性钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)对2型糖尿病(T2DM)伴射血分数降低心衰(HFrEF)患者的治疗效果。方法:选取某院2023年1月—2024年1月收治的T2DM伴HFrEF患者86例为研究对象,采用随机数字表法分为观察组和对照组,...目的:观察高选择性钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)对2型糖尿病(T2DM)伴射血分数降低心衰(HFrEF)患者的治疗效果。方法:选取某院2023年1月—2024年1月收治的T2DM伴HFrEF患者86例为研究对象,采用随机数字表法分为观察组和对照组,各43例。对照组常规降糖和抗心衰治疗,观察组在对照组基础上联合SGLT2i治疗。比较2组血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)]、血清心功能指标[N末端B型钠尿肽前体(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2)]、左心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]及不良反应发生率。结果:治疗3个月后,观察组FPG[(6.91±1.45)mmol/L]、HbA1c[(6.72±1.40)%]水平低于对照组[(7.50±1.17)mmol/L、(7.25±1.17)%](P<0.05),2组2h PBG水平比较差异无统计学意义(P>0.05);观察组NT-proBNP[(1551.04±567.79)pg/mL]、sST2[(22.15±4.38)ng/mL]水平低于对照组[(1845.75±482.22)pg/mL、(25.79±6.34)ng/mL](P<0.05);观察组LVESD[(46.19±5.18)mm]、LVEDD[(52.02±5.12)mm]低于对照组[(48.58±5.29)mm、(54.89±5.98)mm],LVEF[(36.36±1.76)%]高于对照组[(35.49±2.15)%],差异均有统计学意义(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论:SGLT2i对T2DM伴HFrEF治疗效果良好,可有效降低患者血糖水平,减少心肌纤维化和心肌重构,使心脏获益。展开更多
The evolution of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has resulted in mutations not only in the spike protein,aiding immune evasion,but also in the NSP3/4/6 proteins,crucial for regulating double...The evolution of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has resulted in mutations not only in the spike protein,aiding immune evasion,but also in the NSP3/4/6 proteins,crucial for regulating double-membrane vesicle(DMV)formation.However,the functional consequences of these NSP3/4/6 mutations remain poorly understood.In this study,a systematic analysis was conducted to investigate the evolutionary patterns of NSP3/4/6 mutations and their impact on DMV formation.The findings revealed that the NSP4 T492I mutation,a prevalent mutation found in all Delta and Omicron sub-lineages,notably enhances DMV formation.Mechanistically,the NSP4 T492I mutation enhances its homodimerization,leading to an increase in the size of puncta induced by NSP3/4,and also augments endoplasmic reticulum(ER)membrane curvature,resulting in a higher DMV density per fluorescent puncta.This study underscores the significance of the NSP4 T492I mutation in modulating DMV formation,with potential implications for the transmission dynamics of SARS-CoV-2.It contributes valuable insights into how these mutations impact viral replication and pathogenesis.展开更多
文摘目的:观察高选择性钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)对2型糖尿病(T2DM)伴射血分数降低心衰(HFrEF)患者的治疗效果。方法:选取某院2023年1月—2024年1月收治的T2DM伴HFrEF患者86例为研究对象,采用随机数字表法分为观察组和对照组,各43例。对照组常规降糖和抗心衰治疗,观察组在对照组基础上联合SGLT2i治疗。比较2组血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)]、血清心功能指标[N末端B型钠尿肽前体(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2)]、左心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]及不良反应发生率。结果:治疗3个月后,观察组FPG[(6.91±1.45)mmol/L]、HbA1c[(6.72±1.40)%]水平低于对照组[(7.50±1.17)mmol/L、(7.25±1.17)%](P<0.05),2组2h PBG水平比较差异无统计学意义(P>0.05);观察组NT-proBNP[(1551.04±567.79)pg/mL]、sST2[(22.15±4.38)ng/mL]水平低于对照组[(1845.75±482.22)pg/mL、(25.79±6.34)ng/mL](P<0.05);观察组LVESD[(46.19±5.18)mm]、LVEDD[(52.02±5.12)mm]低于对照组[(48.58±5.29)mm、(54.89±5.98)mm],LVEF[(36.36±1.76)%]高于对照组[(35.49±2.15)%],差异均有统计学意义(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论:SGLT2i对T2DM伴HFrEF治疗效果良好,可有效降低患者血糖水平,减少心肌纤维化和心肌重构,使心脏获益。
基金supported by the National Natural Science Foundation of China(92469107 to Z.Li)the R&D Program of Guangzhou National Laboratory(ZL-SRPG2200205 to Z.Li)the Guangdong Province High-level Talent Youth Project(2021QN02Y939 to Z.Li).
文摘The evolution of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has resulted in mutations not only in the spike protein,aiding immune evasion,but also in the NSP3/4/6 proteins,crucial for regulating double-membrane vesicle(DMV)formation.However,the functional consequences of these NSP3/4/6 mutations remain poorly understood.In this study,a systematic analysis was conducted to investigate the evolutionary patterns of NSP3/4/6 mutations and their impact on DMV formation.The findings revealed that the NSP4 T492I mutation,a prevalent mutation found in all Delta and Omicron sub-lineages,notably enhances DMV formation.Mechanistically,the NSP4 T492I mutation enhances its homodimerization,leading to an increase in the size of puncta induced by NSP3/4,and also augments endoplasmic reticulum(ER)membrane curvature,resulting in a higher DMV density per fluorescent puncta.This study underscores the significance of the NSP4 T492I mutation in modulating DMV formation,with potential implications for the transmission dynamics of SARS-CoV-2.It contributes valuable insights into how these mutations impact viral replication and pathogenesis.
