兰索拉唑对2型糖尿病患者血糖及胃泌素的影响

Effects of lansoprazole therapy on the plasma glucose and gastrin in the patients with type 2 diabetes mellitus

目的观察兰索拉唑能否缓解2型糖尿病(T2DM)患者口服二甲双胍引起的胃肠道不适,并探讨其对血糖、血清胃泌素(Gastrin)的影响及其可能的机制。方法将51例患者分为兰索拉唑组(n=26)和对照组(n=25),观察治疗前后空腹血糖(FBG)、糖化血红蛋白(HbA1C)、Gastrin、空腹胰岛素(FINS)、血脂、肝肾功及尿酸(UA)的变化。结果兰索拉唑组治疗后胃部不适症状明显减轻,有效缓解率95.0%,症状缓解时间(3.05±1.07)d;空腹胃泌素水平较治疗前升高[(158.26±11.85)vs(95.61±4.48)ng/L,P<0.05],治疗后FBG[(7.22±0.45)vs(7.70±0.29)mmol/L,P<0.05]和HbA1C[(7.28±0.76)%vs(7.85±0.05)%,P<0.05]均显著低于对照组;治疗前后,兰索拉唑组FBG的变化[(1.16±0.62)vs(0.51±0.45)mmol/L,P<0.05]及HbA1C的变化[(0.64±0.50)vs(0.33±0.43)mmol/L,P<0.05]均较对照组具有统计学意义(P<0.05)。相关回归分析显示,兰索拉唑组治疗后Gastrin升高与其HbA1C下降相关(r=-0.605,P<0.05)。结论兰索拉唑可以改善二甲双胍引起的胃部不适并能降低T2DM患者血糖水平,其作用可能与Gastrin的升高有关。

Objective To observe whether lansoprazole can alleviate the discomfort of gastrointestinal symptoms caused by metformin and investigate the effects of lansoprazole on the blood glucose, gastrin and potential mechanism in the type 2 diabetes mellitus. Methods Fifty-one patients with T2DM were enrolled and divided into the lansoprazole group （n = 26） and control group （n = 25 ）. We measured the levels of indicators such as fasting blood glucose（ FBG）, gly- cosylated hemoglobin（HbA1C） , gastrin, fasting insulin（ FINS）, lipid, hepatic and renal function, and serum uric acid （UA） before and after treatment. Results Lansoprazole could alleviate the discomfort of gastrointestinal symptoms which caused by metformin, and the effective remission rate was 95.0%. After （ 3.05 ± 1.07 ） days, the symptoms were fully remitted. The levels of the gastrin were significantly increased in the lansoprazole group [ （ 158.26 ± 11.85 ） vs （95.61 ± 4.48 ） rig/L, P 〈 0.051. The levels of the FBG [ （7.22 ± 0.45 ） vs （7.70 ± 0.29 ） mmol/L, P 〈 0.05 ） ] and HbAl C [ （7.28 ± 0.76） % vs （ 7.85 ± 0.05 ） % , P 〈 0.05 ] in the lansoprazole groups were significantly declined in comparison with the control group after treatment. The changes of FBG （ 1.16 ± 0.62 vs 0.51 ± 0.45, P 〈 0.05 ） and HbA1C in the lansoprazole group （0.64 ±0.50 vs 0.33 ± 0.43 ,P 〈 0.05 ） were significantly different in compari- son with the control group（ P 〈 0.05 ）. Correlation regression analysis showed that the decrease of HbAI C was associat- ed with the gastrin rising （ r = - 0. 605, P 〈 0.05 ）. Conclusion Lansoprazole can alleviate the discomfort of gastroin- testinal symptoms caused by metformin and reduce the blood glucose levels in T2DM patients, which may be related with the increase of gastrin.