吡咯列酮对2型糖尿病患者基质金属蛋白酶-9干预效果的临床研究  

The dinical study of the intervention effect of drug on artherosderosis in type 2 dibetes mellitus

作　　者：薛现中[1] 宋永涛[2] 任忠法[1] 郭宏[1] 

机构地区：[1]山东省滕州市中心人民医院,277500 [2]山东省滕州市卫生职业中等专业学校,277500

出　　处：《中国医学创新》2009年第13期41-43,共3页Medical Innovation of China

摘　　要：目的观察吡格列酮对2型糖尿病患者基质金属蛋白酶-9（MMP-9）的影响并探讨其可能机理。方法选择符合WHO1999年诊断标准的2型糖尿病患者65例，随机分成治疗组（33例）和对照组（32例）。治疗组降糖药物选用胰岛素或磺脲类＋吡格列酮；对照组仅用胰岛素或磺脲类控制血糖，其他常规治疗药物中不用二甲双胍、血管转换酶抑制剂、阿司匹林、他汀类、维生素C、维生素E等药物．疗程6个月。所有患者治疗前后均于清晨空腹抽血，留取标本，用于基质金属蛋白酶-9（MMP-9）的测定。结果65例患者共有61例完成了本观察，两组患者治疗后MMP-9较治疗前有明显降低（均P〈0．05），治疗后两组相比治疗组MMP-9下降水平明显高于对照组（P〈0．01）。在治疗中无1例患者出现明显不良反应。结论吡格列酮除具有降血糖作用外，还具有降低糖尿病患者血中MMP-9水平，改善2型糖尿病患者抗动脉粥样硬化能力的作用。Objective To evaluate the effect of pioglitazone on artherosclerosis in type 2 diabetes patients and to approach the possible mechanism. Methods 65 cases of type 2 diabetes patients who in accord with diagnostic criteria of WHO 1990 were randomly divided into the therapy group（ n = 33 ） and the control group（ n = 32 ）. Choose insulin or sulfonylureas with or without pioglitazone as therapy drug. The therapy course was 6 months. Changes of MMP - 9 and oxLDL of fasting blood were observed in the therapy group and the control group before and after the trial. Results 61 cases completed this obervation. The level of MMP -9 of fasting blood decreased obviously after treatment both in therapy group and control group （ both P 〈 0.01 ）. The level of MMP - 9 of fasting blood of therapy group decreased more obviously than control group after treatment（ P 〈0. 01 ） . There was no patient with obviously adverse reaction. Conclusion Pioglitazone has an role of anti - artherosclerosis independent of its hypoglycemic activity. It can degrade the level of MMP - 9 in diabetic and improve the ability of anti - artherosclerosis of diabetes patients.

关 键 词：2型糖尿病 吡格列酮 基质金属蛋白酶-9 动脉粥样硬化 

分 类 号：R735.2[医药卫生—肿瘤] R587.1[医药卫生—临床医学]