吡格列酮对2型糖尿病患者血清C反应蛋白和肿瘤坏死因子-α的影响

Effect of pioglitazone on levels of serum C-reactive protein and tumor necrosis factor-α in patients with type 2 diabetes

目的:观察吡格列酮治疗对2型糖尿病(T2DM)患者血清炎症因子C-反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)水平的影响。方法:采用随机、双盲法将2型糖尿病患者90例分为对照组和吡格列酮组,对照组联合应用磺脲类和双胍类药物,吡格列酮组每天加服吡格列酮15mg治疗12周,分别检测两组治疗前后空腹血糖(FPG)、2h血糖(2hPG)、糖化血红蛋白(HbAlc)、血清CRP、TNF-α水平,评估治疗前后胰岛素抵抗(IR)变化。结果:对照组糖化血红蛋白(HbAlc)显著下降(P<0.01),其他指标无显著变化;吡格列酮组治疗后FPG、2hPG、HbAlc、IR显著降低(P<0.01),血清CRP、TNF-α水平治疗后显著下降(P<0.01),与对照组比较差异有极显著性(P<0.01)。结论:吡格列酮治疗T2DM能改善胰岛素抵抗、降低血糖,具有明显的抗炎作用。

Objective：To observe the effect of pioglitazone on the levels of serum C-reactive protein（CRP）and tumor necrosis fac-tor-α（TNF-α）in the patients with type 2 diabetes.Methods：The randomized,double-blind method was used to divided 90 cases of type 2 diabetes into control group of 45 cases and pioglitazone group of 45 cases.Sulfonylurea and biguanide drugs were combined used in the control group.Additional 15mg pioglitazone was used in pioglitazone group each day for 12 weeks.Fasting plasma glucose（FPG）,2h glucose（2hPG）,glycosylated hemoglobin（HbAlc）,serum CRP and TNF-α levels of two groups were assessed before and after treatment.Insulin resistance（IR）changes were evaluated too.Results：HbA1c in control group decreased（P0.01）.Other indicators had no significant changes.FPG,2hPG,HbA1c and insulin resistance index in pioglitazone group after treatment were significantly decreased（P0.01）.Serum CRP and TNF-α levels in pioglitazone group significantly decreased after treatment（P0.01）,which were significantly different with the control group（P0.01）.Conclusion：Pioglitazone treatment of T2DM can improve insulin resistance and lower blood glucose,suggesting that pioglitazone has obvious anti-inflammatory effect.