目的:研究罗格列酮(ROS)治疗2型糖尿病,对患者组织胰岛素敏感性与血清炎症介质改变的关系。方法:选取符合1999年WHO标准确诊的2型糖尿病患者30例。试验采用前后自身配对方法。口服ROS 4mg每天一次,总疗程8周。测定指标包括常规临床检查项目、血糖,同时检测血浆胰岛素水平,糖化血红蛋白(HbA1c)水平、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,以 HOMA模型和胰岛素钳夹试验评价组织胰岛素敏感性。结果:应用ROS治疗的2型糖尿病患者组织胰岛素敏感性显著改善(Plt;0.05),并降低血浆CRP、IL-6、TNF-α水平,这些炎症介质的改变与组织胰岛素敏感性的改变相关。结论:应用ROS治疗2型糖尿病能降低患者血浆炎症介质水平,减轻胰岛素抵抗,延缓或减轻糖尿病大血管并发症的发生发展。
摘要:目的: 观察格列美脲对2型糖尿病患者心血管的保护作用并探讨其可能的机制。 方法 :112例T2DM患者随机分为格列美脲组(格列美脲+二甲双胍)和对照组(格列本脲+二甲双胍),观察治疗前后两者空腹及餐后两小时血糖(FBG,2hPBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、HOMA模型胰岛素抵抗指数(HOMAIR)、甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、同型半胱氨酸(HCY)、血浆脂联素的变化。 结果 :两组患者的TC、LDLC、TG、FBG、2hPBG都较治疗前降低,连续服用6个月以上格列美脲的T2DM患者其血浆HCY、HOMAIR、血糖水平明显下降,血浆脂联素水平明显升高,与对照组相比差异有统计学意义(〖WTBX〗P lt;005)。 结论 :格列美脲能降低多项心血管危险因子水平,对血脂、HCY和动脉粥样硬化都有良性调节作用,其作用基础可能与改善胰岛素抵抗,增加血浆脂联素相关。Abstract: Objective: To observe the protective effects and to explore mechanisms of glimepiride on cardiovascular system of Type 2 Diabetes Mellitus. Methods : 112 patients with type 2 diabetes mellitus were randomly divided into treatment group (glimepiride combined with metformin) and control group (glibenclamide combined with metformin). The fasting blood glucose (FBG), 2hPBG, hemoglobin A1c (HbA1c), FINS, HOMAIR, blood lipid (TC, TG, LDLC and HDLC), HCY (homocysteine) and adiponectin were detected before and after treatment. Results : In all cases, the level of TC、LDLC、TG、FBG、2hPBG were decreased after treated with glimepiride or glibenclamide combined with metformin for 6 monthes. Moreover, the level of HCY, HOMAIR and blood glucose were decreased and the level of adiponectin was increased significantly than that of in control group (Plt;005). Conclusion : Glimepiride showed the effective on decreasing the risk factor of cardiovascular system disease with regulation of blood lipid, HCY, and improve the atherosclerosis. The effective of glimepiride on cardiovascular system was relation to improved the insulin resistance and increase the adiponectin.