不同磺脲受体基因对格列齐特治疗Ⅱ型糖尿病的效果影响  

Gliclazide sulfonylurea receptor gene in different therapeutic effects on typeⅡdiabetes

作　　者：谷磊[1] 赵家胜[2] 宣淼[2] 

机构地区：[1]上海市同济医院急诊科,上海200065 [2]上海市同济医院内分泌科,上海200065

出　　处：《西部医学》2015年第4期526-528,共3页Medical Journal of West China

摘　　要：目的探讨不同磺脲受体基因对格列齐特治疗Ⅱ型糖尿病的影响,为临床治疗Ⅱ型糖尿病提供理论依据。方法选取接受格列齐特治疗的Ⅱ型糖尿病患者124例,用Taqman-PCR技术检测患者的磺脲受体基因,根据基因型分为C/C组、C/T组和T/T组,对所有患者给予格列齐特片40mg,2次/d,于第15天和第30天测患者血糖水平。试验前后分别测定空腹血糖(FPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)以及胰岛β细胞功能指数(HOMA-β)。血糖>6.0mmol/L的患者,加大1倍剂量,疗程8周,比较不同基因型对治疗效果的影响。结果三组患者在年龄、平均病程、性别,以及治疗前后体重指数(BMI)和腰臀比(WHR)各组间比较差异无统计学意义(P>0.05)。治疗前3种基因的FPG、HbA1c、HOMA-IR及HOMA-β组间比较差异无统计学意义(P>0.05)。与治疗前相比,治疗后C/C组、C/T组和T/T空腹血糖FPG、HbA1c、HOMA-IR以及HOMA-β水平明显下降。治疗后,C/C组患者HbA1c水平与T/T组、C/T组比较,差异均有统计学意义(P<0.05),且C/C组降低较T/T、C/T组更明显;T/T型基因组患者治疗后HOMA-β水平与C/C组和C/T组相比,有明显提高(P<0.05)。结论磺脲受体基因多态性对格列齐特治疗Ⅱ型糖尿病有一定的修饰作用,且T/T基因型对糖尿病的治疗效果更为明显。Objective To investigate the relationship between the poly-morphism of sulfonylurea receptor and decreased the blood glucose of gliclazide. Methods 124 patients with type 2 diabetic treated with gliclazide were divided into genotype C/C group, C/T group and the T/T group. The sulfonylurea receptor gene was detected by Taqman-PCR technique. The patients were treated with Gliclazide Tablets 40mg, 2 times/d. The blood sugar levels were measured at 15 days and 30 days after treatment. Fasting plasma glucose were measured before and after the test （FPG）, glycated hemoglobin （HbAlc）, insulin resistance index （HOMA-IR） and pancreatic β-cell function index （HOMA-β）. Glucose 6.0mmol/L in patients, increase a double dose for 8 weeks, compared the impact of different genotypes and treatment. Results Three groups of patients was not statistically significant （P〉0.05） in age, average duration, sex, and body mass index before and after treatment （BMI） and waist-hip ratio difference （WHR） among the groups. Before treatment three genes FPG, HbAle, HOMA-IR and HOMA-β difference between the groups was not statistically significant （P〉 0.05）. Compared with before and after treatment, C/C group, C/T group and T/T fasting plasma glucose FPG, HbAlc, HOMA-IR and HOMA-β levels were significantly decreased. T/T patients with HbAlc decreased significantly higher than the other two genotype s Inter-group comparison. The T/T genotype group of patients HOMA-β levels compared with C/C and C/T group have significantly improved （P^0.05）. Conclusion Sulfonylurea receptor gene polymorphisms on gliclazide treatment of type 2 diabetes have some modification, and the treatment effect of T/T genotype of diabetes is more obvious.

关 键 词：磺脲受体基因 格列齐特 Ⅱ型糖尿病 效果 

分 类 号：R587.1[医药卫生—内分泌]