Evaluation Of Energy Metabolism With Creatine Phosphate In The Elderly Age Diabetes Mellitus Complicating Heart Failure Patients

Backgroud Diabetes mellitus(DM) is the independent risk factor of heart failure (HF), the final consequence in majority of diabetics cardiac suffering developing to HF, internal and abroad research have made clear that insulin signal transduction pathway between the cardiac muscle utilization energy substrate and the genetic expression which determine energy generate or expend existences significant correlate, the cardiac muscle energy metabolism supportive treatment is a kind of prospect method as a adjunctive therapeutic measure in HF, demand even more preferable study.Objective To investigate the effection of myocardium energy metabolism with creatine phosphate(CP) and pancreatic island function in the elderly DM complicating HF patients, and interpret the mechanism of action with energy metabolism supportive treatment measure in this kinds of patients.Methods Sixty elderly age DM complicating HF patients(NYHA cardiac functional gradingâ…¢-â…£stage) were scheduled for this study in Third-level First-class Hospital. They were randomly divided into control group(30 cases) and study group(30 cases) after sign informed consent. Keeping blood sugar, blood pressure and blood fat to reach purpose and giving routine treatment prescription to control group, base on this study group add CP,2.0g,ivgtt,Qd*14d.Empty blood preparation were be obtained pretherapy and post-treatment, biochemistry index were used by complete automatic instrument, insulin and C-peptide were determined by radio-immunity, HbA1c were applied by high pressure liquid chromatography, the plasma brain natriuretic peptide (BNP) the adenine monophosphate(AMP) activated protein kinase(AMPK) were applied by solid phase sandwich method in enzyme linked immunosorbent assay (ELISA).All perform the heart ultrasonic inspection to evaluate the cardiac function.Results Compared to pretherapy two groups have obtained significant improvement in 6 min walking test(6MWT), LVFF,FS,E/A ratio, there is significance difference(P <0.05).Group comparison show that 6MWT,E/A ratio have significant difference(P <0.05) in study group,and LVEF,FS have no significant difference(P>0.05) in group comparison. Compared to pretherapy two groups have obtained significant improvement in plasma index BNP,AMPK and pancreatic island function index IR,ISI, there is significance difference(P< 0.05).Group comparison show that AMPK, IR have significant difference(P<0.05) in study group,and BNP,ISI have no significant difference(P> 0.05) in group comparison. Study group obtain an advantage than control group.Conclusion The elderly age DM complicating HF patients all existence the cardiac muscle energy metabolic block, insulin resistance(IR) and myocardium contraction or dilatation function damage, CP be able to achieve significant enhancing myocardium energy metabolism, partly correcting IR and regulating myocardial relaxation function through increase activity of AMPK, lighten IR and improve myocardium energy substrate availability, improving the clinical symptom and prognosis.