吡格列酮对老年2型糖尿病患者的作用

Effects of Pioglitazone on Elderly Patients with Type 2 Diabetes Mellitus

目的:观察吡格列酮对老年2型糖尿病(T2DM)患者血糖、血脂的作用。方法:将血糖控制不佳的64例T2DM患者按照年龄分为老年组(32例)和非老年组(32例),每组又按照随机区组设计分为安慰剂组、吡格列酮单药组、吡格列酮+磺脲类组、吡格列酮+二甲双胍组,每组8例,早餐前30 min口服实验药物,疗程为3月,分别于治疗前后检测空腹血糖(FBG)、糖化血红蛋白(HbA1C)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)及肝功能、血常规。结果:治疗3月后,吡格列酮单药组和2个联合治疗组FBG、HbA1C、TG均显著降低,HDL-C升高,且2个年龄组间无显著性差异,2个联合治疗组分别有4例和3例减少了原磺脲类和二甲双胍的用量。无1例出现不良反应。结论:吡格列酮显著改善老年T2DM患者的血糖、血脂参数,是老年T2DM患者较理想的降糖药物。

Objective： To study the effects of pioglitazone on elderly patients with type 2 diabetes mellitus （T2DM）. Methods： T2DM patients （n=64） without well-controlled blood glucose were divided into the senile group （≥60 years, n=32） and non-senile group （〈60 years, n=32）. Each group was also divided into the placebo group （n=8）, pioglitazone group （n=8）, pioglitazone＋ sulfonylurea group （n=8） and pioglitazone＋metformin group （n=8） by the rule of randomized block design. After three-months treatment, fasting blood glucose （FBG）, HbA1C, triglyceride （TG）, high＇density lipoprotein-cholesterol （HDL-C）, hepatic function and blood routine were measured. Results： Compared with those in the placebo group, the serum levels of FBG, HbA1C and TG in the pioglitazone monotherapy group and the pioglitazone combination therapy group were significantly lower （P〈0.05） and the level of HDL-C was markedly higher （P〈0.01）. No significant difference was found between the two groups of different ages. There were four patients who reduced the sulfonylurea dosage and three patients who reduced the metformin. No patients had side effects. Conclusion： Pioglitazone could significantly improved glycaemic and lipid parameters in elderly patients with T2DM. It is an ideal medicine for elderly patients.