二氯醋酸二异丙胺改善糖尿病患者脂代谢紊乱的再评价  

A reevaluation of diisopropylamine dichloroacetate for its improvement of lipid metabolic disorder of diabetic patients

作　　者：刘赫[1,2] 韩萍[3] 杜建玲[4] 梁琳琅[5] 董玉梅[6] 武红梅[7] 王晓露[8] 窦艳华[9] 施克新[10] 刘国良[1] 

机构地区：[1]中国医科大学附属第一医院内分泌科,沈阳110001 [2]北京协和医学院 [3]中国医科大学盛京医院 [4]大连医科大学第一医院 [5]沈阳军区总医院 [6]辽宁省人民医院 [7]辽宁医学院附属医院 [8]鞍山市中心医院 [9]锦州市中心医院 [10]葫芦岛市中心医院

出　　处：《中国糖尿病杂志》2011年第4期290-292,共3页Chinese Journal of Diabetes

摘　　要：目的观察二氯醋酸二异丙胺(DIPA)对2型糖尿病(T2DM)患者脂代谢紊乱等的影响及安全性。方法对辽宁地区8个中心的TG≥4.0 mmol/L的T2DM患者240例进行随机阳性药物平行对照研究,DIPA组、非诺贝特组各120例。结果 (1)两组治疗10 d、30 d后TG均显著下降(P<0.01);静脉滴注10 d后DIPA组TG下降4.53 mmol/L,非诺贝特组下降3.37 mmol/L,两组差异有统计学意义(P=0.036);继续口服20 d后两组分别下降5.45、4.33 mmol/L,两组差异无统计学意义(P=0.132)。(2)两组HDL-C在治疗前后及组间比较均无统计学差异(P>0.05)。(3)两组TC及LDL-C治疗后均下降(P<0.01),但组间差异无统计学意义(P>0.05)。(4)治疗30 d后DIPA组ALT明显下降(P<0.01),非诺贝特组无明显下降(P>0.05)。结论 DIPA可明显改善糖尿病患者的TG、TC、LDL-C,疗效与非诺贝特相当,从ALT复常率的变化来看,DIPA不损害肝细胞功能。Objective To observe the therapeutic effects and safety of diisopropylamine dichloroacetate （DIPA） in improving lipid metabolic disorder of diabetic patients. Methods A randomized controlled trial with parallel positive drug was performed in 240 type 2 diabetic patients with TG≥4. 0 mmol/L selected from 8 centers of Liaoning province. These patients were randomly divided into 2 groups： DIPA group （n=120） and fenofibrate group （n=120）. Results （1）TG in both groups was significantly reduced after 10 or 30 days treatment （P〈0. 01）. After the first 10 days treatment, the serum TG was reduced by 4. 53 mmol/L in DIPA group, and 3. 37 mmol/L in fenofibrate group （P=0. 036）. At the end of the 30 days treatment, the TG level was reduced by 5. 45 mmol/L in DIPA group and by 4. 33 mmol/L in fenofibrate groups. （2）There was no significant difference in HDL-C between two groups. （3）Both TC and LDL-C were significantly reduced （P〈0. 01）, but there was no difference between two groups （P 〉 0. 05）. （4） After 30 days treatment, ALT in DIPA group was recuced signicantly （P〈0. 01）, but there was no difference in ALT level in fenofibrate group （P〈0. 05）. Conclusions Like fenofibrate, DIPA is an effective and safe drug in treating lipid metabolic disorder of diabetic patients. But considering the normalization of ALT, DIPA may also protect the liver function.

关 键 词：二氯醋酸二异丙胺 非诺贝特 糖尿病 2型 甘油三酯 丙氨酸氨基转移酶 

分 类 号：R587.1[医药卫生—内分泌]