胰岛素吡格列酮对胰岛β细胞功能的影响  

Effects of Treatment of Pioglitazone Combined with Insulin on Beta-cell Function

作　　者：李青菊[1] 李鹏诺[1] 田晨光[1] 张苏和[1] 李凤良[1] 

机构地区：[1]郑州大学第二附属医院内分泌科,郑州市450014

出　　处：《医药论坛杂志》2005年第1期32-34,共3页Journal of Medical Forum

摘　　要：目的　观察胰岛素、吡格列酮对 2型糖尿病胰岛β细胞功能的影响。方法　将 60例 2型糖尿病患者分为两组:胰岛素加吡格列酮组和磺脲类降糖药物加吡格列酮组治疗 1年,分析对比两组治疗前后空腹及餐后 2h血糖、糖化血红蛋白、空腹胰岛素原、空腹真胰岛素和由Homa模型计算的HomaIR。结果　治疗后两组患者血糖和糖化血红蛋白均维持良好水平,但组间无差异;治疗后胰岛素原水平和IR两组均明显下降,胰岛素组较磺脲组降低更明显;治疗后胰岛素组的真胰岛素水平较磺脲组明显增高。结论　对经饮食和运动后血糖不能获得良好控制的 2型糖尿病患者应用胰岛素或磺脲类药物联合吡格列酮治疗均能改善胰岛β细胞功能和IR,且胰岛素治疗比磺脲类药物能使β细胞的负荷进一步减少。Objective To investigate the effect of pioglitazone combined with insulin on β-cell function in type 2 diabetes. Methods 60 diabetes patients were divided into two groups by treating with insulin and pioglitazone, or sulfonylureas and pioglitazone for a year. Compare the fasting 2h blood glucose and the postprandial blood glucose, the glycosylated hemoglobin (GHb), the level of 2h proinsulin and insulin in fasting state, and the Homa IR before and after the treatment in two groups. Results In both groups the blood glucose and GHb are under good control, and there was no significant difference in two groups; the proinsulin level and Homa IR decreased significantly after the treatment, and the effect was more obvious in insulin group than in sulfonylureas group. The real insulin level in insulin group is significantly higher than that of the sulfonylureas group. Conclusion The combination use of insulin or sulfonylureas with pioglitazone both could improve the function of β cells and alleviate the IR state in type 2 groups whose blood glucose could not be well controlled by diet and exercises, and the use of insulin is better than sulfonylureas in improving β-cell function.

关 键 词：2型糖尿病 胰岛素 吡格列酮 胰岛Β细胞 

分 类 号：R587.1[医药卫生—内分泌]