罗格列酮钠对2型糖尿病患者糖脂代谢及胰岛素抵抗的影响  

An influence of rosiglitazone on glycaemic and lipid metabolism and insulin resistance of T2DM patients

作　　者：曾兆良[1] 熊红霞[1] 李锦华[1] 

机构地区：[1]广西医科大学附属第四医院,柳州545005

出　　处：《重庆医学》2008年第22期2592-2593,共2页Chongqing medicine

摘　　要：目的探讨罗格列酮钠(ROS)对2型糖尿病(T2DM)患者糖脂代谢及胰岛素抵抗的影响。方法将48例已口服磺脲类(SU)和双胍类(BG)药物治疗3个月以上、血糖仍控制不良的T2DM患者随机分为两组。ROS组为磺脲类和双胍类加用ROS,对照组为磺脲类和双胍类,两组患者在观察期间磺脲类和双胍类药物剂量保持不变,在此基础上,ROS组加用ROS4mg/d,于治疗前及治疗后12周测定空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbAlc)胰岛素(Ins)、C肽(C-P)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、胰岛素抵抗指数(HOMA-IR)FPG×FIns/22.5及胰岛素敏感指数(ISI)1/(FPG×Fins)、肝脏酶谱、谷丙转氨酶(GPT)、谷草转氨酶(GOT)、谷氨酰转移酶(γ-GT)。结果两组患者治疗12周后ROS组FPG、2hPG、HbAlc、Ins、C-P、TG、HOMA-IR均比对照组明显下降,差异有统计学意义(P<0.05)。HDL-C、ISI比对照组明显升高,差异有统计学意义(P<0.05)。结论ROS于其他降糖药物联合应用不仅能有效降低长期控制不佳T2DM的血糖、血脂水平,还能降低胰岛素抵抗,提高胰岛素敏感性,从而改善胰岛素功能和预防血管并发症发生,并有良好安全性。Objective To study the influence of rosiglitazone on glycaemic and lipid metabolism and insulin resistance. Methods 48 patients with T2DM whose blood glucose was not well controlled after taking oral hypoglycemic agents sulphonylureas（SU） and biguanides（BG） for 3 months were divided into 2 groups randomly （group ROS and controlled group）. In group ROS,patients took rosiglitazone together with SU and biguanide,in controlled group, patients took SU and biguanide only. Patients of both groups took unchanged doses of SU and biganide during the observation period. Patients in group ROS took an additional dose of rosiglitazone（4mg/d）. Fasting blood glucose（FBG） ,2-hours postprandial blood glucose（2HPG） ,glyeosylated haemoglobin（HbAlc） ,insulin （INS） ,peptide-C（C-p）,total cholesterol（TC）, triglyeeride （TG）,high density lipoprotein cholesterol （HDL-C）,low density lipoprotein cholesterol （LDL C） ,insulin resistance index （HOMA IR,FBG X Fins/22.5）and insulin sensitivity index（ISI ） 1/（FBG × Fins）, liver enzyme series including glutamic-pyruvic transminase （GPT）, y-glutamie oxaloacetic transminase （ GOT）, glutamyl transpeptidase（γ-GT） were tested before treatment and after receiving treatment for 12 weeks in both groups. Results FBG, 2HPG, HbAlc,Ins,C P,TG, HOMA-IR in group ROS tended to drop more obviously than those of their respective counterparts in the controlled group after treating 12 weeks. The difference was remarkable（P〉0.05）. HDL-C tended to rise more obviously than its counterpart in the controlled group,and there was a statistical significance in the rise （P〈0.05）. Conclusion The association of rosiglitazone with other oral hypoglycemic agents not only helps to reduce blood glucose and blood lipid of T2DM patients which have not been controlled for a long time effectively, but also helps to reduce insulin resistance, and to increase the sensibility of insulin,as well as to improve B cell function of pancreas and to preven

关 键 词：2型糖尿病 胰岛素抵抗 罗格列酮钠 

分 类 号：R587.1[医药卫生—内分泌]