罗格列酮联合治疗血糖控制不良的老年2型糖尿病患者临床观察

Efficacy of rosiglitazone in treatment of elderly type 2 diabetes with poor glycerin control

目的观察罗格列酮对联合使用磺脲类、双胍类而血糖控制不好的老年2型糖尿病患者的疗效。方法对97例联合使用磺脲类、双胍类而血糖控制不好的老年患者分为罗格列酮＋磺脲类＋双胍类组（A组）、罗格列酮＋胰岛素组（B组）及胰岛素组（C组），治疗12周，治疗前后测定患者空腹、餐后2h血糖，空腹、餐后2h胰岛素，糖化血红蛋白、甘油三酯、总胆固醇、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶、谷氨酰转肽酶等指标，计算胰岛素抵抗指数及体重指数。结果治疗后3组的空腹及餐后2h血糖显著下降（P〈0．01）、糖化血红蛋白显著下降（P〈0．05），组间比较差异无统计学意义，A组的空腹胰岛素降低，A、B两组的胰岛素抵抗指数改善（P〈0．05）。结论对联合使用磺脲类、双胍类而疗效不好的2型糖尿病患者加服罗格列酮可显著降低血糖，是抗拒使用胰岛素者一个较好的选择。

Objective To evaluate the clinical efficacy of rosiglitazone in treatment of type 2 diabetics with poor glycerin combined with sulfonylureas and mefformin. Methods The 97 elderly type 2 diabetes were divided into three groups and receive treatment within 12 weeks. Diabetes in group A were treated with ＂Rosiglitazone ＋ Sulfonylureas ＋ Metformin＇. Diabetes in group B were treated with ＂Rosiglitazone ＋ Insulin＂. Diabetes in group C were treated with insulin. Before and after treatment, all groups were observed the blood glucose（ FBG）, two hours after lunch blood glucose （2 h PBG） ,FINS, PINS, HbA1 c, TG, CHO, AST, ALT and R - GT, and carefully evaluate the HOMA - IR and BMI. Resuits After treatment, the blood glucose（FBG） and two hours after lunch blood glucose （2 h PBG） of the diabetes were obviously decreased （ P 〈 0. 01 ）, HbAlc was obviously decreased （ P 〈 0.05 ）. There was no obvious difference. FBG in Group A were decreased. Insulin resistance index in group A and group B were improved （ P 〈 0.05）. Conclusions The blood glucose can be obviously decreased in treatment of elderly type 2 diabetes with rosiglitazone. It is a better choice for insulin - resisted diabetes.