罗格列酮对2型糖尿病患者的长期疗效观察

Long-tern therapeutic effect observation of Rosiglitanzone in treatment of type 2 diabetic patients.

目的观察罗格列酮对2型糖尿病(T2DM)患者的长期疗效和安全性。方法采用自身治疗前后对照法,对单用或格列吡嗪加治疗,血糖控制欠佳的 T2DM 患者59例加用罗格列酮治疗,进行3年随访,对血糖下降至空腹<5.5mmoL/L 或餐后2h<6.5mmoL/L 的病人减少格列吡嗪剂量7.5mg/d,观察治疗前后血糖、糖化血红蛋白(HbA_1c)。空腹胰岛素(FINS),空腹 C-肽(FC-P),稳态模型胰岛素抵抗(HomaIR)指数,高敏 C 反应蛋白(hsC-RP)及格列吡嗪用量。结果加服罗格列酮后,FPG、2hPG、HbA_1c、FINS、FC-P、hsC-RP 均明显下降,HomaIR 明显改善(P<0.01),格列吡嗪用量明显减少,至实验结束时共有28例患者完全停用格列吡嗪而血糖控制良好。结论单用格列吡嗪或格列吡嗪加二甲双胍疗效欠佳的 T2DM 患者加服罗格列酮能长期有效控制血糖,减少或停用原联合应用的格列吡嗪。

Objective To observe the long-tern efficacy and safety of rosiglitazone in treatment of type 2 diabetic pa- tients.Methods 59 patients on a regimen of glipizide or glipizide+mefformin with poor glycaemic control were added rosiglitasone 8mg/d and observed for 3 years,and the dose of glipizide would be reduced 7.5mg/d when FPG<5. 5mmol/l or 2hPG<6.5 mmoL/l.Plasma glucose,HbA_1c,fast insulin(FINS),fast C-peptide(FC-P),HomaIR,high sensitivity C-reactive protein(hsC-RP)were measured and the doses of glipizide were recorded before and 6,12,18, 24,36 after the treatment with rosiglitazone.Results After treatment with rosiglitazone,plasma glucose,HbA_1c,FINS, FC-P,HomaIR,hsC-RP were decreased and the dose of glipizide were reduced.Conclusion Glipizide or glipizide +metformin in patients with T2DM of poor service rosiglitazone plus long-term effective control of blood glucose levels, reduced or suspended the application of the Joint glipizide.