探讨纤溶酶原激活物抑制因子-1水平对评价2型糖尿病短期强化治疗疗效的临床意义  

Effect of different short-term intensive treatment methods on plasminogen activator inhibitor-1 in newly diagnosed type 2 diabetic patients

作　　者：胡晓燕 王茜[1] 徐宽枫[1] 刘翠萍[1] 覃又文[1] 茅小东[1] 刘超[1] 

机构地区：[1]南京医科大学第一附属医院内分泌科

出　　处：《临床内科杂志》2007年第7期461-463,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨甘精胰岛素联合二甲双胍或格列美脲联合二甲双胍两种强化治疗方案对初诊2型糖尿病患者β细胞功能和血清纤溶酶原激活物抑制因子-1(PAI-1)水平的影响。方法将36例空腹血糖(FBG)为7.0～11.0mmol/L的初诊2型糖尿病患者随机分为两组,第一组20例采用甘精胰岛素联合二甲双胍治疗,第二组16例采用格列美脲和二甲双胍联合治疗,分别在诊断初和强化治疗3个月时测定FBG、餐后2小时血糖(PBG)、糖基化血红蛋白(HbA1c)、PAI-1,胰岛素和C肽第二时相分泌量、15例患者加测胰岛素和C肽第一时相分泌量、以HOMA模型计算胰岛素抵抗指数(HOMA-IR)和β细胞敏感指数(HOMA-β)。结果治疗后,两组患者的FBG、PBG和HbA1c均获得良好控制,HOMA-IR和HOMA-β显著改善,两组第一时相及第二时相胰岛素及C肽分泌量显著升高,PAI-1则显著升高。结论甘精胰岛素联合二甲双胍或格列美脲联合二甲双胍短期强化治疗可有效改善β细胞功能,治疗后血清PAI-1的水平较治疗前显著增加。Objective To investigate the effect of different short-term intensive treatment methods on β-cell function and plasminogen activator inhibitor-1 （ PAI-1 ） in newly diagnosed type 2 diabetic patients. Methods 36 newly diagnosed type 2 diabetic patients with fasting blood glucose （FBG） 7.0-11. 0mmol/L were randomized to two groups. The patients were treated with either glargine and metformin or glimepiride and metformin for 3 months. FBG,postprandial blood glucose （PBG）,HbAlc,PAI-1 were measured,the second phase insulin and C peptide secretion were detected. The first phase insulin and C peptied secretion were also measured in part of these patients. HOMA model was used to evaluate β-cell function and insulin resistance. Results Excellent control of FBG,PBG and HbAlc was achieved after 3 months＂ intensive treatment. HOMA-IR,HOMA-β were improved significantly, the first and the second phase insulin and C peptide secretion were also elevated significantly, though PAI-1 level increased remarkably. Conclusions Excellent β-cell function and insulin sensitivity improvement can be achieved with short-term intensive anti-glycemic therapy using the combination therapy of either glargine with metformin or glimepirid with mefformin, though PAI-1 level increased remarkably after being treated.

关 键 词：2型糖尿病 血糖 Β细胞功能 血清纤溶酶原激活物抑制因子-1 

分 类 号：R587.1[医药卫生—内分泌]