吡格列酮对2型糖尿病患者血浆纤溶酶原激活物抑制剂-1的影响

Effect of Pioglitazone on Plasminogen Activator Inhibitor1 of Plasma in Type 2 Diabetic Mellitus Patients

目的:探讨吡格列酮对2型糖尿病(T2DM)患者血浆纤溶酶原激活物抑制剂-1(PAI-1)的影响。方法:70名T2DM患者,随机双盲分为安慰剂组(A组,35例)和吡格列酮组(B组,35例),治疗3个月后,检测两组患者服药前后空腹血糖(FBG)、空腹胰岛素(FINS)、糖基化血红蛋白(HbA1c)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、组织型纤溶酶原激活物(t-PA)和纤溶酶原激活物抑制剂-1(PAI-1),并计算胰岛素敏感指数(ISI)。结果:治疗后吡格列酮组FBG、FINS、HbA1c、TG、PAI-1明显下降(P<0.01),HDL-C、ISI显著升高(P<0.01),t-PA无明显变化,且PAI-1与FINS、TG呈正相关(r=0.437,r=0.342,P<0.05),与ISI呈负相关(r=-0.552,P<0.01);安慰剂组各参数于治疗前后无显著性差异。结论:吡格列酮能够显著降低T2DM患者的PAI-1。

Objective： To study the effect of pioglitazone on plasminogen activator inhibitor-l（PAI-1） of plasma in type 2 diabetic mellitus （T2DM） patients. Methods： T2DM patients （n=70） were divided into the placebo group （n=35） and pioglitazone group （n=35） by the rule of random and double-blind. Before treatment and 3 months later, fasting blood glucose （FBG）, fasting insulin （FINS）, HbA1 c, triglyceride （TG）, high density lipoprotein-cholesterol （ HDL-C）, tissue-plas- minogen activator（t-PA） and PAI-1 were measured. The insulin sensibility index （ISI） was calculated. Results： In the pioglitazone group, the levels of F BG, FINS, HbAlc, TG and PAI-1 were significantly decreased and the values of ISI and HDL-C were markedly increased（P〈0.01） after treatment. The API value had positive correlation to FINS and TG（r=0. 437 and r=0. 342, respectively, each P〈0.05）, and had negative correlation to ISI （r=-0.552,P〈0.01）. In the placebo group, there were no significant differences in the levels of FBG, FINS, HbA1c, ISI, TG, HDL-C, t-PA and PAI-1 before and after treatment. Conclusion： Pioglitazone could significantly reduce PAI-1 in T2DM patients.