吡咯列酮对2型糖尿病患者氧化低密度脂蛋白影响的临床研究

Effect of pioglitazone on oxidized low density lipoprotein in type 2 dibetes mellitus

目的观察吡格列酮对2型糖尿病患者氧化低密度脂蛋白（OXLDL）的影响并探讨其可能的发生机制。方法选择符合WHO1999年诊断标准的2型糖尿病患者65例，随机分成治疗组（33例）和对照组（32例）。治疗组降糖药物选用胰岛素或磺脲类＋吡格列酮，对照组仅用胰岛素或磺脲类控制血糖，其他常规治疗药物中不使用二甲双胍、血管转换酶抑制剂、阿斯匹林、他汀类、维生素c、维生素E等药物。疗程6个月。所有患者治疗前后均于清晨空腹抽血留取标本，用于氧化低密度脂蛋白（OXLDL）的测定。结果65例患者共有61例完成了本观察，两组患者治疗后OXLDL较治疗前明显降低（P均〈0．05）；治疗后治疗组OXLDL下降水平明显高于对照组（P〈0．01）。治疗中无一例患者出现明显不良反应。结论吡格列酮除具有降血糖作用，同样具有降低糖尿病患者血中OXLDL水平，改善2型糖尿病患者抗动脉粥样硬化的能力。

Objective To observe the effect of pioglitazone on oxidized low-density lipoproteins （OXLDL） in type 2 diabetes patients and investigate the possible mechanism. Methods Sixty-five patients with type 2 diabetes mellitus who in accord with diagnostic criteria of WHO 1990 were randomly divided into therapy group （n = 33） and control group （n = 32）. Choose insulin or sulphanylureas with or without pioglitazone as therapy drug. The therapy course was 6 months. Changes of OXLDL of fasting blood were observed in the therapy group and the control group before and after the trial. Results Sixty- one cases completed this obervation. The level of OXLDL of fasting blood decreased obviously after treatment both in therapy group and control group （ all P 〈 0. 05 ）. The level of OXLDL of fasting blood of therapy group decreased more obviously than control group after treatment （ （P 〈 0. 01 ）. There was no patient with obviously adverse reaction. Conclusions Pioglitazone has the effect of hypoglycemia and decrease serum OXLDL level, improve the antiartherosclerosis ability of type 2 diabetes mellitus patients.