二甲双胍对汉族Ⅱ型糖尿病作用机制的探讨

目的 :探讨二甲双胍 (格华止 )在Ⅱ型糖尿病中的作用机制。方法 :选择 6 6名饮食及运动失效的Ⅱ型糖尿病患者 ,开始为期四个月的二甲双胍 (格华止 )口服治疗 ,观察治疗前后空腹血糖 (FBS)、糖化血红蛋白(HbA1c)、甘油三脂 (TG)、乳酸 (lacticacid)、纤溶酶原激活物抑制剂 -I(PAI -I)、C肽 (C -Peptide)、体重变化。结果 :二甲双胍显著降低FBS、TG、Hba1c、PAI-I ,在超重组降低体重 ,消瘦组无体重改变 ,血乳酸在使用二甲双胍后部分患者明显升高 ,其余轻度升高。结论 :二甲双胍能抑制肝糖输出而降低FBS ,抑制脂肪分解而降低TG ,增加外周细胞胰岛素的敏感性 ,并降低高PAI-I及减轻血清高胰岛素血症 ,降低大血管事件的发生 ,降低体重机制未明。二甲双胍 (格华止 )可作为Ⅱ型糖尿病一线用药 ,而在无禁忌症的Ⅱ型糖尿病患者中使用。

Objective:to study the metabolic effects and mechanism of metformin on patients with type-Ⅱ mellitus. Methods: we select 66 patients after failing to diet and exercise to oral metformin for four months and oberve FBS、 HbA1c、TG、Lactic acid、PAI-1、Fins、C-peptide、weight change before and after therapy with metfornin. Results: metformin treatment signficantly decrease FBS、 HbA1C、 PAI-1、 TG and cause weight loss in overweight group, but weight unchange in thin and normal group. Serum lactic acid signfinicantly increased in some patients, slightly increased and unchanged in most patients.Conclusion: Metformin can reduce FBS by inhibiting hepatic glucose output (HGP) decrease TG by inhibiting lipidolysis and increasing the sensitivity of peripheral tissue to insulin and reducing PAI-I and improving fibrolysis by which to improve insulin resistence and decreasing the incidence rate of macrovascular events.The mechanism by which metformin cause weight loss is still unknown.Metformin can be used in first line drug in treatment for type-Ⅱ diabetes.