噻唑烷二酮治疗血糖控制不佳肥胖2型糖尿病的临床观察

Clinical Observation of Thiazolidinedione on Non-control Glucose in Patients with Type 2 Diabetes

目的:研究噻唑烷二酮类药对血糖控制不佳的肥胖2型糖尿病患者的疗效。方法:对94例体质量指数(BMI)≥25.1kg/m2,并且使用非磺脲类促泌剂(诺和龙)联合二甲双胍治疗后糖化血红蛋白(HbA1c)>7.0%的2型糖尿病患者,在制定合理的饮食和运动方案的基础上,随机分为加用马来酸罗格列酮4mg/d组(A组)和盐酸吡格列酮30mg/d组(B组)以及对照(保持原治疗方案不变)组(C组),连续观察16周,观察治疗前后血糖、血脂和肝功能等指标的变化。结果:A、B组治疗后各项指标差异无统计学意义(P>0.05),但与治疗前相比均有明显好转(P<0.01),各组的不良反应差别无统计学意义(P>0.05);A、B组各项指标均优于C组(P<0.05)。结论:不同的胰岛素增敏剂可以同样明显地改善胰岛素抵抗、改善脂代谢。

Objective： To observe the effect of thiazolidinedione on non-control glucose in patients with type 2 on HbA1c, lipoprotein and liver function. Methods： Ninety-four cases of type 2 diabetes which BMI ≥ 25.1kg/m^2 and HbAlc 〉 7.0% after using repaglinide and mefformin were included in this study. Based on a systemic diet and exercise, all patients were divided into three groups which included rosiglitazone 4mg/d group, pioglitazone 15mg/d group and control group. The changes of FBG, 2hPG, HbAlc, TG, TC, HDL-C, ALT and AST were observed for 16 weeks. Results： There was no statistical significance between two observe groups （P 〉 0.05）, but had an improvement after treatment compared with before （P 〈 0.01）. There was no statistic significance in side effect between two observe groups （P 〉 0.05）. All index in two observe groups were better than that in control group （ P 〈 0.05 ）. Conclusion： Different thiazolidinediones can significantly change insulin resistant and lipoprotein metbolism.