【摘要】 目的 觀察羅格列酮加二甲雙胍聯(lián)合治療對(duì)2型糖尿病患者的降糖作用和安全性以及對(duì)胰島素抵抗的影響。 方法 對(duì)2007年8月-2008年5月收治的2型糖尿病患者53例采用自身前后對(duì)照研究，48例符合入選條件的患者，接受羅格列酮加二甲雙胍為期12周治療。試驗(yàn)開始和結(jié)束日測(cè)定患者空腹血糖（fast plasma glucose，F(xiàn)PG）、血清胰島素（serum insulin，F(xiàn)INS）、總膽固醇（total cholesterol，TC）、甘油三酯（triglyceride，TG）、高密度脂蛋白膽固醇（high-density lipoprotein cholesterol，HDL-C）和糖化血紅蛋白（glycosylated hemoblobin，HbA1c）以及標(biāo)準(zhǔn)餐后2 h血糖（postprandial 2 hours blood glucose，2hPPG）和胰島素（postprandial 2 hours insulin，2hPINS）。胰島素敏感性采用HOMA2模型公式評(píng)價(jià)。 結(jié)果 12周時(shí)FPG、FINS、2hPINS、 HbA1c均較治療前基線時(shí)下降，分別為（8.16±2.37） mmol/L與（6.57±1.90） mmol/L，（8.84±8.07） mU/L與（7.28±6.84） mU/L，（26.87±3.13） mU/L與（20.18±13.25） mU/L，7.60%±1.71%與6.79%±1.82%，差異有統(tǒng)計(jì)學(xué)意義（P lt;0.05）。胰島素抵抗指數(shù)顯著低于治療前（2.77±0.90與3.74±1.61，P lt;0.05）。其余代謝參數(shù)變化差異無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）。 結(jié)論 羅格列酮加雙胍類藥物聯(lián)合治療2型糖尿病能有效降2型糖尿病患者的血糖水平，提高胰島素敏感性，不增加體重，無(wú)低血糖發(fā)生，是一種安全有效的治療方案。
【Abstract】 Objective To observe the effect and security of rosiglitazone plus metformin in patients with type 2 diabetes mellitus, and the effect on insulin resistance. Methods Forty-eight cases suitable for this study were accepted and compared from August 2007 to May 2008. Patients accepted rosiglitazone plus metformin for 12 weeks. Fasting plasma glucose (FPG), serum insulin (FINS), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA1c), postprandial 2 hours blood glucose and postprandial 2 hours insulin were determined at the first and last day of this study. HOMA 2 model formula evaluation was used in testing insulin sensitivity. Results After a 12-weeks’ treatment, FPG, FINS, 2hPINS, and HbA1c of patients were lower than those before treatment [(8.16±2.37) mmol/L vs (6.57±1.90) mmol/L; (8.84±8.07) mU/L vs (7.28±6.84) mU/L; (26.87±19.31) mU/L vs (20.18±13.25) mU/L; 7.60%±1.71% vs 6.79%±1.82%; P lt;0.05)]. Insulin resistance index was lower than that after treatment (2.77±0.90 vs 3.74±1.61, P lt;0.05). Other metabolic related parameter had no statistical difference (P gt;0.05). Conclusion Rosiglitazone plus metformin treatment of type 2 diabetes mellitus is effective both in reducing in blood glucose levels and improving insulin sensitivity, and without gain weight, incidence of hypoglycemia. It is a safe and effective option.
引用本文： 鮮楊,朱顯軍,李蓬秋,張學(xué)軍,吳冀川,包明晶,楊艷,張磊,牛顏麗. 羅格列酮加二甲雙胍聯(lián)合治療2型糖尿病的療效觀察. 華西醫(yī)學(xué), 2010, 25(8): 1406-1408. doi: 復(fù)制
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- 1. 楊玉芝, 馮琨, 王丹, 等. 羅格列酮獨(dú)特的作用機(jī)理及其在2型糖尿病理性化治療中的應(yīng)用[J]. 實(shí)用糖尿病雜志, 2005, 13(1): 10-12.
- 2. Schernthaner G, Forst T, Gulba D, et al. Challenge in diabetes therapy: effects of glitazones beyond blood glucose control[J]. Dtsch Med Wochenschr, 2009, 8(4): 949-54.
- 3. Chao-Hung Wang, Ching-Hsiang Leung, Sung-Chen Liu, et al. Safety and Effectiveness of Rosiglitazone in Type 2 Diabetes Patients with Nonalcoholic Fatty Liver Disease[J]. Formosan Medical Association, 2006, 105(9): 743-752. .
- 4. Fadia T, Shaya MPH, James, et al. Medicaid managed care: disparities in the use of thiazolidinediones compared with metformin[J]. The National Medical Association, 2005, 97(4): 493-497. .
- 5. Asche CV, McAdam-Marx C, Shane-McWhorter L, et al. Association between oral antidiabetic use adverse events and outcomes in patients with type 2 diabetes[J]. Diabetes Obesity and Metabolism, 2008, 10(8): 638-645. .
- 6. Benton CR, Holloway GP, Campbell SE, et al. Rosiglitazone increases fatty acid oxidation and fatty acid translocase(FAT/CD36)but not carnitine palmitoyltransferase I in rat muscle mitochondria[J]. Physiol, 2008, 15(6): 1755-1766.