吡格列酮对2型糖尿病患者臂踝脉搏波传导速度的影响

The effects of pioglitazone on brachial-ankle pulse wave velocity in patients with type 2 diabetes mellitus

目的探讨吡格列酮对2型糖尿病患者臂踝脉搏波传导速度(baPWV)的影响,以及baPWV与颈动脉内膜—中层厚度(IMT)的关系。方法将90例2型糖尿病患者随机分为治疗组、对照组,均接受常规降糖治疗,在此基础上,治疗组加服吡格列酮,在第1疗程6个月结束后,比较两组颈动脉IMT的变化,同时对两组患者的baPWV进行检测,继续第2个疗程的吡格列酮对比治疗,6个月后复查baPWV。结果第1疗程结束后治疗组颈动脉IMT明显降低,对照组颈动脉IMT明显升高;baPWV随着颈动脉IMT的降低而下降,在吡格列酮第2个疗程治疗后baPWV仍有降低的趋势,治疗组治疗前后相比差异有显著性(P<0.05),对照组治疗前后相比差异无显著性(P>0.05)。结论baPWV与颈动脉IMT有明显关系,吡格列酮可降低2型糖尿病患者的颈动脉IMT和baPWV,延缓其大血管病变的发生发展。

Objective To investigate the effects of piogliazone on brachial - ankle pulse wave velocity （baPWV） in patients with type 2 diabetes mellitus, and to discuss the relation between baPWV and carotid artery intimal - medial thickness （IMT）. Methods 90 hospitalized patients with type 2 diabetes mellitus were randomly divided into two groups： the pioglitazone group and the control group. Patients in both of the two groups received conventional treatment, while the patients in pioglitazone group received oral pioglitazong 15mg, qd, as well. A comparison of the carotid artery IMT changes between the two groups was performed and the baPWV was measured in both groups after the first course of 6 - month treatment. The baPWV was reexamined and compared between the two groups after the second course of 6 - month treatment. Results The follow - up after the first course of treatment showed that carotid artery IMT reduced significantly in the pioglitazone group, whereas, the control group increased, the baPWV was positively associated with the carotid artery IMT. The baPWV still lowered after the second course of pioglitazone treatment. There was statistical difference in the pioglitazone group, compared before, treatment with after treatment（P〈 0.05）, but there was no difference in the control group （P〉 0.05）. Conclusion The baPWV is positively correlated with carotid artery IMT, pioglitazone can reduce carotid artery IMT and baPWV in patients with type 2 diabetes mellitus, and can prevent the development of macrovascualr complications.