老年男性2型糖尿病患者并发动脉粥样硬化与罗格列酮的干预效应  

Interventional effects of rosiglitazone in type 2 diabetes elderly male patients combined with atherosclerosis

作　　者：张一娜[1] 崔璨[1] 范鹰[1] 常曼丽[2] 吴威[1] 于卫刚[1] 刘枫晨[3] 谭宁[3] 张巾超[3] 

机构地区：[1]哈尔滨医科大学附属第二医院老年病科,黑龙江省哈尔滨市150086 [2]哈尔滨医科大学附属第二医院临床检验科,黑龙江省哈尔滨市150086 [3]哈尔滨医科大学附属第二医院内分泌科,黑龙江省哈尔滨市150086

出　　处：《中国临床康复》2005年第39期58-61,共4页Chinese Journal of Clinical Rehabilitation

基　　金：中央干部保健委员会专项基金(黑B055)~~

摘　　要：目的:探讨噻唑烷二酮类药物对老年男性2型糖尿病患者的抗动脉粥样硬化作用,并了解该种作用发生的相关因素。方法:①选择2002-03/2003-03哈尔滨医科大学附属第二医院老年病科门诊就诊的男性2型糖尿病患者45例。符合纳入标准的2型糖尿病患者24例,均签署知情同意书。随机将受试者分为3组:对照组(给予格列吡嗪5mg/次,3次/d),罗格列酮4mg/d组(给予罗格列酮4mg/次,1次/d)和罗格列酮8mg/d组(给予罗格列酮8mg/d),每组8例。本实验共进行6个月。根据罗格列酮治疗3个月糖化血红蛋白下降的情况又分为2亚组:反应亚组(n=10,下降>1%为反应亚组)和非反应亚组(n=6,下降<1%为非反应亚组)。②于服药前,服药后3,6个月分别测定身高、体质量、收缩压、舒张压、空腹血糖、糖化血红蛋白、空腹血浆胰岛素、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、三酰甘油及高敏C反应蛋白、纤维蛋白原和颈动脉内膜中层厚度。并计算胰岛素抵抗指数和体质量指数。血浆胰岛素采用双相、双步时间依赖性荧光免疫法测定。高敏C反应蛋白运用比浊法检测。纤维蛋白原运用CA-1500全自动血栓/止血测定系统枸橼酸抗凝血浆检测。颈动脉内膜中层厚度应用高分辨B-型超声仪测定。③各组间比较应用方差分析,组内治疗前后比较应用HotellingT2检验。应用Pearsson相关分析和多元线性回归分析影响颈动脉内膜中层厚度的因素。结果:实验过程中无因肝肾功能改变以及药物不耐受而退出试验者,24例均进入结果分析。①对照组治疗3和6个月后空腹血糖,糖化血红蛋白,三酰甘油水平明显低于治疗前(P<0.01),其余指标无显著改变。罗格列酮治疗组在治疗3和6个月后空腹血糖、糖化血红蛋白、胰岛素抵抗指数、三酰甘油、纤维蛋白原,C反应蛋白和颈动脉内膜中层厚度明显低于治疗前(P<0.05～0.01);罗格列AIM： To study the effects of thiazolidinediones （TZDs） on antiatherosclerosis in elder male patients with type 2 diabetes, and understand related factors induced this function. METHODS： ① Forty-five male patients wit^1 type 2 diabetes, who were diagnosed at the outpatient clinic of Department of Geriatrics, Second Affiliated Hospital of Harbin Medical University from March 2002 to March 2003, were selected. Twenty-four patients with type 2 diabetes were accorded with the inclusion criteria, and all signed the informed consents. The testees were assigned randomly into 3 groups： control group （treated with glipizide 5 mg every time, 3 times a day）, rosiglitazone 4 mg per day group （giving 4 mg rosiglitazone every time, once a day） and rosiglitazone 8 mg per day group （giving 8 mg rosiglitazone per day） with 8 cases in each group. This experiment was performed for 6 months totally. According to treatment for 3 .months with rosiglitazone and the decrease of glucose ferrohemoglobin, they were divided into 2 subgroups： response subgroup （n=10, decrease by 〉 1%） and no response subgroup （n=6, decrease by 〈1%）. ② The changes in height, body mass, systolic pressure, diastolic pressure, fasting glucose, glycosylated hemoglobin, fasting serum insulin, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triacylglycerol, high sensitivity C-reactive protein, fibrinogen and carotid intermedium thickness were measured at the time of beginning, 3 and 6 months after management. The insulin resistance index （IRI） and body mass index were calculated. Plasm insulin was detected with two-phase-Step time dependence fluorescent immunization method. The high sensitivity C-reactive protein was detected with turbidimetry. The fibrinogen was detected with CA-1 500 full automatic thromb/hemostasis system citric acid anti-coagulated blood method. The carotid intermedium thickness was detected with high-resolution B-ultrasound. ③ Group comparison and endogr

关 键 词：动脉硬化/药物疗法 噻唑类 酮类 糖尿病 非胰岛素依赖型/并发症 

分 类 号：R587.1[医药卫生—内分泌]