初诊2型糖尿病患者那格列奈血药浓度与疗效的相关性研究  

Correlation between Plasma Concentration of Nateglinide and Clinical Efficacy in Newly Diagnosed Type 2 Diabetes

作　　者：朱余兵[1] 赵拯[1] 刘赟心[1] 马建华[2] 

机构地区：[1]南京医科大学附属南京医院南京市第一医院药学部,南京210006 [2]南京医科大学附属南京医院南京市第一医院内分泌科,南京210006

出　　处：《中国药师》2017年第1期94-95,98,共3页China Pharmacist

基　　金：江苏省药学会百特生物药学基金科研项目(编号:百特009)

摘　　要：目的:考察使用那格列奈治疗的初诊2型糖尿病患者血药浓度与临床疗效的相关性。方法:73例初诊2型糖尿病患者在饮食控制及体育锻炼基础上,三餐前口服那格列奈,疗程2个月,监测治疗期间出现的不良反应,观察治疗前后空腹血糖(FBG)、空腹C肽(F-CP)、餐后2h血糖(2h-PG)、餐后2h C肽(P-CP)、糖化血红蛋白(Hb Alc)的变化,并于治疗最后1天静脉取血,采用LC-MS法测定血药浓度。结果:治疗后患者FBG、2h-PG、Hb Alc显著降低、P-CP显著升高,差异有统计学意义(P<0.05),F-CP虽较治疗前略有升高,但差异无统计学意义(P>0.05);那格列奈血药浓度与治疗前后Hb Alc差值、P-CP差值均呈正相关(P<0.05)。结论:初诊2型糖尿病患者使用那格列奈可获得良好的疗效及安全性,那格列奈血药浓度可作为临床胰岛功能改善和降糖药效学评价的新方法。Objective： To study the correlation between plasma concentration and clinical efficacy in newly diagnosed type 2 diabe- tes treated with nateglinide. Methods： On the basis of diet control and exercise, 73 cases of newly diagnosed type 2 diabetes received nateglinde therapy for 2 months. Adverse events were routinely monitored during the therapy. Fasting blood glucose （FBG）, 2h post- prandial blood glucose （2h-PG）, fasting C-peptide （ F-CP）, 2h C-peptide （P-CP） and glycosylated hemoglobin （ HbA1 c） were ob- served before and after the treatment. LC-MS was used to determine the plasma concentration of nateglinide on the last day of treat- ment. Results： FBG, 2h-PG, HbAlc and P-CP after the treatment had significant changes when compared with those before the treat- ment （P 〈0.05）. There was no significant difference in F-CP in spite of minor increase （P 〉0.05）. The difference in HbAlc and P- CP before and after the treatment both showed a significantly positive correlation with plasma concentration of nateglinide （ P 〈 0.05 ）. Conclusion ： Nateglinide displays good clinical efficacy and safety in newly diagnosed type 2 diabetes, and its plasma concentration can be used to evaluate the pancreatic islets function and glucose-lowing effects.

关 键 词：初诊2型糖尿病 那格列奈 血药浓度 临床疗效 相关性 

分 类 号：R977.15[医药卫生—药品]