吡格列酮对糖调节受损患者的临床干预

Effect of Pioglitazone on Impaired Glucose Regulation

目的观察吡格列酮对糖调节受损(IGR)患者糖、脂代谢的影响。方法将60例糖调节受损门诊初诊患者随机分为两组。两组均进行一般行为干预。干预组在此基础上给予吡格列酮15 mg/d,连续12周。干预前后分别测定身高、体重、腰围、臀围、血压、空腹血糖(FBG)及胰岛素(FINS)、餐后2 h血糖(2hBG)及胰岛素(2hINS)、糖化血红蛋白(HbA1c)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、肾功、肝功,并计算体质量指数(BMI)及腰臀比(WHR)。结果对照组干预前后各项指标均无明显变化;干预组干预前后体重、腰臀比、肾功、肝功无变化;干预后BMI、血压、FBG、2hBG、FINS、2hINS、HbA1c、TC、TG、LDL-C均降低,HDL-C升高,与对照组比较有显著性差异(P<0.05或P<0.01)。结论吡格列酮干预IGR患者,可明显改善其糖、脂代谢及胰岛素抵抗。

Objective To observe the effect of pioglitazone on the metabolism of glucose and lipid in patients with Impaired Glucose Regulation （IGR）. Methods 60 cases of IGR received conventional education on diabetes prevention, while the patients in intervention group （30 cases） accepted pioglitazone 15 mg once a day for 12 weeks. Blood pressure （BP）,body weight, waist eireumfer ence, hip circumference were measured to calculate body mass index （BMI） and waist-hip ratio （WHR）. The Fasting blood glucose （FBG） ,2 h postprandial blood glucose, gleosylated hemoglobin（GHb, HbAle ）, fasting serum insulin（FINS）, postprandial serum in- sulin（2hlNS）, total cholesterol（TC）, triglyeeride（TG）,high-density lipoprotein cholesterol（ HDL C）, low-density lipoprotein eholesterol（LDL-C）, hepatic function, renal function were determined before and 12 weeks after intervention. Results After intervention, BP,BMI,FBG,2hBG,FINS,2hINS,HbA1C,TC,TG,LDL-C had been decreased significantly in intervention group （P〈0.05 or P〈0.01）. There were significant differences between intervention group and control group（P〈0. 05 or P〈0.01 ） in all indexes except body weight,WHR,hepatic function, renal function. Conclusion Pioglitazone can obviously improve the metabolism of glucose and lipid in patients with IGR.