罗格列酮对2型糖尿病患者颈动脉内膜中层厚度的影响

Effects and mechanism of rosiglitazone on carotid intima-media thickness in obese patients with type 2 diabetes mellitus

目的 评价2型糖尿病患者经罗格列酮长期治疗后颈动脉内膜中层厚度（IMT）的变化及机制。方法选择59例2型糖尿病伴肥胖患者，随机分成对照组（29例）与治疗组（30例），治疗组加用罗格列酮治疗24个月，治疗前后应用高频超声检测IMT及基质金属蛋白酶-9（MMP-9）、C-反应蛋白（CRP）的变化。结果与对照组比较，治疗组IMT降低（P〈0．05），治疗组治疗后血清MMP-9与CRP分别为（253．4±97．5）ng／L和（1．15±0．96）mg／L，对照组分别为（361．8±101．7）ng／L和（2．18±2．01）mg／L，两组比较差异有统计学意义（P〈0．01）。结论罗格列酮能延缓2型糖尿病患者颈动脉粥样硬化的进展，其作用机制可能通过改善MMP-9和CRP而实现。

Objective To investigate the effects and mechanism of rosiglitazone on carotid intima-media thickness （IMT） in patients with type 2 diabetes mellitus （DM） by carotid ultrasonography. Methods Fifty-nine patients with obese DM were divided into two groups randomly： patients in control group （n = 29） received routine therapy, and patients in treatment group（ n = 30） received resiglitazone with routine therapy for 24 months. Carotid IMT was measured by carotid ultrasonography pre-and post-therapy. The level of ma-trix metalloproteinase-9 （MMP-9） and C-reactive protein（CRP） were assayed. Results Compared with control group, the IMT was decreased following rosiglitazone therapy （ P 〈 0. 05 ）. The concentrations of MMP-9 and CRP in patients in the treatment group were （253.4±97. 5 ）ng/L and（ 1.15 ± 0.96）mg/L, and those in the control group were （361.8 ±101.7 ）ng/L and （2. 18 ±2. 01 ）mg/L, which were significantly improved. Conclusion Rosiglitazone could retard atherosclerosis progression in obese patients with type 2 DM which was achieved through improving MMP-9 and CRP.