罗格列酮对2型糖尿病患者血浆tPA和PAI1活性的影响

Effect of rosiglitazone on plasma activity of tPA and PAI1 in type 2 diabetes mellitus

目的:运用胰岛素增敏剂罗格列酮治疗2型糖尿病患者,观察罗格列酮对2型糖尿病患者血浆tPA和PAI1活性水平的影响。方法:48例2型糖尿病患者,口服罗格列酮(文迪雅)4mg/d,共12周,观察治疗前后的血浆tPA和PAI1活性、血糖和胰岛素等,计算胰岛素敏感指数和胰岛素抵抗指数,并将各指标进行分析比较。结果:罗格列酮治疗后2型糖尿病患者血浆tPA活性升高(P<0.05),PAI1活性及PAI1/tPA活性比值降低(P<0.05,P<0.01)。血糖、胰岛素水平降低(均P<0.05);胰岛素敏感指数明显升高(P<0.05);胰岛素抵抗指数降低(P<0.05)。结论:罗格列酮在降低血糖、改善胰岛素抵抗、提高胰岛素敏感指数的同时,能增强糖尿病患者纤溶系统的活性,对心血管起到保护作用。

Objective To investigate the effects of insulinsensitizer （rosiglitazone） on the plasma activity of tissue type plasmainogen activator （tPA） and plasminogen activator inhibitor-1 （PAI1） in type 2 diabetes meUitus. Methods Forty-eight patients with type 2 diabetes mellitus received orally rosiglitazone （4 mg/d ） for 12 weeks. The level of plasma activity of tPA and PAI1, blood glucose and insulin were detected before and after treatment with rosiglitazone. Calculated and compared the insulin resistance index and insulin sensitive index. Results After the treatment with rosiglitazone, the plasma activity of tPA was increased significantly（ P 〈 0. 05 ）. The plasma activity of PAI1 and the activity proportionality of PAI1/tPA were decreased significantly（ P 〈 0. 05, P 〈 0. 01）. Blood glucose and insulin was decreased significantly after treatment（ P 〈 0. 05）. The insulin resistance index decreased and insulin sensitive index increased significantly（ P 〈 0. 05） . Conclusion Rosiglitazone can lower level of blood glucose and insulin, improve insulin sensitivity, decrease insulin resistance. Rosiglitazone can enhance the activity of fibfinolytic system. It plays a role of protection in cardiovascular system.