亚莫利对初诊2型糖尿病患者血糖、血脂、胰岛素抵抗和纤溶活性的影响

The Effect of Amaryl on Glycemic Controls, Lipid Profiles, Fibrinolytic Function, Insulin Resistence in Newly Diagnosed Type 2 Diabetes

目的观察亚莫利治疗12周前后血糖、糖化血红蛋白、血脂、纤溶活性和胰岛素抵抗改善情况。方法初诊2型糖尿病患者33例,于入院后禁食8～12h行口服葡萄糖耐量试验,分别于试验前和口服葡萄糖后2h、用葡萄糖氧化酶法测空腹血糖和餐后2h血糖、以及糖化血红蛋白、酶法测血脂、放射免疫法测胰岛素水平、发色低物法测组织型纤溶酶原激活物和纤溶酶原激活物抑制剂1水平,胰岛素抵抗用Homa-IR表示。结果亚莫利治疗后患者血糖达到良好控制,糖化血红蛋白从治疗前8.6%±3.1%降至7.1%±1.6%(P<0.01),且未见明显低血糖。治疗后血清总胆固醇、低密度脂蛋白胆固醇、甘油三酯均较治疗前明显降低,高密度脂蛋白胆固醇有明显升高(P<0.01)。纤溶活性在治疗后获得显著改善,组织型纤溶酶原激活物从治疗前0.225±0.113kIU/L升高至0.457±0.177kIU/L(P<0.01)。纤溶酶原激活物抑制剂1从治疗前0.898±0.168kAU/L降至0.533±0.215kAU/L(P<0.01)。胰岛素抵抗指标Homa-IR也较治疗前明显降低,治疗前为4.11±0.85,治疗后为2.42±0.91(P<0.05)。结论对初诊2型糖尿病患者,亚莫利具有快速稳定控制血糖、改善脂质代谢和显著减轻胰岛素抵抗的作用,改善组织型纤溶酶原活性的作用。

Aim To investigate the effects of Amaryl on newly diagnosed type2 diabetes. Methods 33 newly diagnosed type 2 diabetic patients with fasting plasma glucose （FPG）〈12 mmol/L were treated with Amaryl for 12 weeks. Oral glucose tolerance test （OGTT） was performed before and after Amaryl therapy. The fasting and post 2 h plasma glucose （P2hPG）, hemoglobin A1C （GHbA1C）, Homa-IR, TC, TG, LDLC, HDLC, tissue-type plasminogen activator （tPA） and plasminogen activator inhibitor-1 （PAI-1） were compared before and after Amaryl. Results After 2 weeks′Amaryl treatment, good glycemic control was achieved. The FPG, P2hPG, GHbA1C, TC, TG, LDLC, Homa-IR, tPA were lower than before.But HDLC, PAI-1 were higher than before. Conclusion Excellent glycemic controls, improvements of lipid profiles and PAI-1 and decreased insulin resistence can be induced by Amary therapy in newly diagnosed type 2 diabetic patients.