不同剂量的二甲双胍对IGT患者血糖波动及下肢血管病变影响  

Effects of different doses of metformin on blood glucose fluctuation and lower extremity vascular disease in patients with IGT

作　　者：包智华 张曼丽 娜仁图雅 李艳荣 

机构地区：[1]内蒙古自治区国际蒙医医院西医内分泌科,内蒙呼和浩特010000

出　　处：《现代医学》2017年第9期1328-1333,共6页Modern Medical Journal

摘　　要：目的:研究不同剂量二甲双胍对糖耐量受损(IGT)患者血糖波动及下肢血管病变的影响。方法:采用随机、对照、前瞻性研究,将2013年4月~2014年6月120例IGT患者随机机化分为3组,A组患者给予二甲双胍,500 mg·次-1,1次·d-1,B组给予500 mg·次-1,2次·d-1,C组给予500 mg·次-1,3次·d-1,所有患者均给予等同的运动和饮食干预,30 d为1疗程,共3疗程,对比治疗前后胰岛素抵抗状态、血糖和体重,并随访2年,观察患者下肢血管病变情况。结果:治疗后,C组血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)和糖化血红蛋白(HbA1c)、血糖波动系数、最高血糖]、胰岛素指标[空腹胰岛素水平(FIns)、胰岛素抵抗指数]、血脂均是最低,其次是B组和A组,组间比较有统计学差异(P<0.05);C组胰岛β细胞功能(HOMA-β)最高,其次是B组和A组,组间比较有统计学差异(P<0.05);3组治疗期间发生不良反应率比较无统计学差异(P>0.05);随访2年期间C组未发生下肢血管病变,B组发生2例下肢血管病变,A组发生4例。结论:IGT患者早期采用高剂量的二甲双胍能够有效降低患者血糖波动和代谢指标,在预防下肢血管病变有明显的临床效果。Objective： To study the effects of different doses of metformin on blood glucose fluctuation and lower extremity vascular disease in patients with impaired glucose tolerance（IGT）.Methods： a randomized,controlled,prospective study,120 patients with 2013.4-2014.6 IGT were randomly divided into three groups of machines,A group were treated with metformin,500 mg/time,1 times/day,B group was given 500 mg/time,2 times/day,C group was given 500 mg/time,3 times/day,all patients were given such as exercise and diet intervention at the same time,30 days for a course of treatment,a total of 3 courses of treatment,compared before and after treatment of insulin resistance,blood glucose,body weight,and were followed up for 2 years,to observe the situation of patients with lower extremity vascular disease.Results： the three groups after treatment group C blood glucose index （FPG,2 hPG and HbA1c,the blood glucose fluctuation coefficient,the highest blood glucose insulin index （FINS index）,and insulin resistance,blood lipid） is the lowest,followed by B group and A group,by statistical analysis,P〈0.05,comparison between groups was statistically difference in C group; after the HOMA-beta is highest,followed by B group and A group,by statistical analysis,P〈0.05,comparison between groups was statistically difference; there was no significant difference in the rate of adverse reactions occurred during the treatment in the three groups （P〉0.05）; during 2 years of follow-up C group had no lower extremity vascular disease,B group occurred in 2 cases of lower extremity vascular disease,4 cases occurred in the A group.Conclusion： the early use of high dose of metformin in IGT patients can effectively reduce the blood glucose fluctuations and metabolic indicators,in the prevention of lower extremity vascular disease has obvious clinical effect.

关 键 词：二甲双胍 IGT 血糖波动 下肢血管病变 

分 类 号：R587.1[医药卫生—内分泌]